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使用0.9%生理盐水冲洗行前列腺经尿道切除术患者围手术期的电解质紊乱

Perioperative Dyselectrolytemia in Patients Undergoing Transurethral Resection of the Prostate Using 0.9% Normal Saline Irrigation.

作者信息

Singh Surya P, Barman Hiranmay, Rath Amrita, Singh Rambadan

机构信息

Anaesthesiology, Apex Hospital, Varanasi, IND.

Anaesthesiology, Anandaloke Multispeciality Hospital, Siliguri, IND.

出版信息

Cureus. 2024 May 9;16(5):e59976. doi: 10.7759/cureus.59976. eCollection 2024 May.

Abstract

BACKGROUND

The choice of irrigation fluid used in transurethral resection of the prostate (TURP) has a significant impact on serum electrolyte levels. Among the many available options, 0.9% normal saline (NS) is considered to be more physiological.

MATERIAL AND METHODS

This observational study was conducted on 60 adult males aged 50-70 years, classified as American Society of Anesthesiologists grade 1 and 2, undergoing TURP with 0.9% NS irrigation under spinal anesthesia achieved with a mixture of 0.5% heavy bupivacaine. The patients' hematocrit and serum electrolyte levels were obtained after six hours and compared with preoperative values.

RESULTS

Hematocrit reduced from 40.32 ± 6.27 to 31.07 ± 5.40 (p < 0.001). Both serum sodium and potassium decreased from 136.77 ± 3.27 to 128.31 ± 5.91 and from 4.02 ± 0.26 to 3.81 ± 0.36, respectively (p < 0.001). However, serum chloride showed only a minimal increase from 101.58 ± 2.88 to 102.25 ± 1.66 (p < 0.12).

CONCLUSION

Although the changes in serum sodium and potassium were statistically significant, they did not have any physiological consequences in our study. However, this emphasizes the importance of vigilant electrolyte monitoring to identify and mitigate the risk of electrolyte disturbances during TURP surgeries.

摘要

背景

经尿道前列腺切除术(TURP)中使用的冲洗液的选择对血清电解质水平有重大影响。在众多可用选项中,0.9%的生理盐水(NS)被认为更符合生理状态。

材料与方法

本观察性研究对60名年龄在50 - 70岁的成年男性进行,这些男性被分类为美国麻醉医师协会1级和2级,在脊髓麻醉下接受TURP手术,使用0.5%重比重布比卡因混合物实现麻醉,术中用0.9% NS冲洗。术后6小时获取患者的血细胞比容和血清电解质水平,并与术前值进行比较。

结果

血细胞比容从40.32±6.27降至31.07±5.40(p<0.001)。血清钠和钾分别从136.77±3.27降至128.31±5.91以及从4.02±0.26降至3.81±0.36(p<0.001)。然而,血清氯仅从101.58±2.88略有升高至102.25±1.66(p<0.12)。

结论

尽管血清钠和钾的变化具有统计学意义,但在我们的研究中它们并未产生任何生理后果。然而,这强调了在TURP手术期间进行警惕的电解质监测以识别和减轻电解质紊乱风险的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/872a/11164244/cb3713d5a9c2/cureus-0016-00000059976-i01.jpg

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