Tong Xuan Hung, Dinh Thi Thu Trang, Ngo Van Dinh, Nguyen Minh Ly
Department of Anesthesiology and Pain Medicine - 108 Military Central Hospital, Hanoi, Vietnam.
Res Rep Urol. 2021 Jun 1;13:297-301. doi: 10.2147/RRU.S288614. eCollection 2021.
Transurethral resection of the prostate (TURP) syndrome is a complication of transurethral resection of the prostate procedure. The incidence of TURP syndrome ranges from 0.78% to 1.4%. This syndrome is caused by excessive absorption of electrolyte-free and hypotonic washing solution. The fluids absorb into the circulation, which leads to heart failure, hyponatremia, and a decrease in serum osmolality. Cerebral edema, coma, pulmonary edema, cardiovascular collapse, and even death are common complications.
We report a patient who suffered severe TURP syndrome after transurethral resection of the prostate procedure. Clinical manifestations were pulmonary edema and respiratory failure. The concentration of Na was 112.6 mmol/l, which was severe hyponatremia. The serum osmolality pressure was 234mOsmol/kg, pH was 7.23, pO was 45mmHg and pCO was 44mmHg. The patient had successfully recovered after being used CPAP-PSV Pro breathing through a mask with + 5cmHO of PEEP, 8cmHO of supporting pressure, 70-100% of FiO, 20mg furosemide of intravenously, 150 mL of 3% NaCl, and 100mL natribicarbonate 8.4%.
TURP syndrome is a life-threatening complication of transurethral resection of the prostate procedure, which is caused by excessive absorption of electrolyte-free and hypotonic washing solution. Therefore, the patient should be monitored seriously, diagnosed early, and treated promptly.
经尿道前列腺电切术（TURP）综合征是经尿道前列腺电切手术的一种并发症。TURP综合征的发生率在0.78%至1.4%之间。该综合征是由无电解质和低渗冲洗液的过度吸收引起的。液体吸收进入循环系统，导致心力衰竭、低钠血症和血清渗透压降低。脑水肿、昏迷、肺水肿、心血管衰竭甚至死亡是常见的并发症。
我们报告了一例经尿道前列腺电切术后发生严重TURP综合征的患者。临床表现为肺水肿和呼吸衰竭。血钠浓度为112.6 mmol/l，属于严重低钠血症。血清渗透压为234mOsmol/kg，pH值为7.23，pO为45mmHg，pCO为44mmHg。通过面罩使用CPAP-PSV Pro模式呼吸，呼气末正压（PEEP）为+5cmH₂O，支持压力为8cmH₂O，吸入氧浓度（FiO₂）为70 - 100%，静脉注射20mg呋塞米，静脉滴注150 mL 3%氯化钠溶液和100mL 8.4%碳酸氢钠后，患者成功康复。
TURP综合征是经尿道前列腺电切手术的一种危及生命的并发症，由无电解质和低渗冲洗液的过度吸收引起。因此，应对患者进行严密监测，早期诊断并及时治疗。
