Harzmann R, van Deyk K, Flüchter S H, Bichler K H
Eur Urol. 1982;8(4):216-21. doi: 10.1159/000473521.
Easily manipulable, noninvasive techniques for the immediate recognition of absorption of irrigating solution in transurethral prostate resections have not previously been available. For this reason, a way was sought to bring about an improvement in this situation: changes in the thoracic ground impedance were studied perioperatively by use of impedance cardiography during 16 transurethral resections. Furthermore, measurement of central venous pressure and arterial blood gases was done simultaneously as well as registration of myocardial function by systolic time intervals. Most important among the changes caused by absorption of irrigating solution which were registered with impedance cardiography are a significant increase in cardiac output and a considerable decrease in arterial oxygen pressure. Furthermore, a strong correlation was found between the increase of central venous pressure and the decrease of thoracic ground impedance. The relation of the preejection period to the left ventricular ejection time showed a significant increase due to impairment of myocardial function. The results show that impedance cardiography can monitor the time and extent of absorption of irrigating solution exactly and immediately and thus allows immediate therapy. This noninvasive technique can thus be used for perioperative supervision of the patient during transurethral prostate resections.
以前，经尿道前列腺切除术时能即时识别灌洗液吸收情况的易于操作的非侵入性技术并不存在。因此，人们寻求一种方法来改善这种状况：在16例经尿道前列腺切除术中，通过使用阻抗心动图对术中胸壁基础阻抗的变化进行研究。此外，同时进行中心静脉压和动脉血气测量以及通过收缩期时间间期记录心肌功能。在通过阻抗心动图记录的灌洗液吸收引起的变化中，最重要的是心输出量显著增加和动脉氧分压大幅下降。此外，发现中心静脉压升高与胸壁基础阻抗降低之间存在很强的相关性。由于心肌功能受损，射血前期与左心室射血时间的关系显示出显著增加。结果表明，阻抗心动图能够准确、即时地监测灌洗液吸收的时间和程度，从而实现即时治疗。因此，这种非侵入性技术可用于经尿道前列腺切除术患者的围手术期监测。
