Tolksdorf W, Goetz D, Peters H J, Potempa J, Lutz H
Infusionsther Klin Ernahr. 1980 Jun;7(3):148-54.
In 24 patients undergoing transurethral resection (TUR) of the prostate, sodium, potassium, calcium, magnesium, osmolarity and protein in serum were measured every 15 min. Depending on the composition of the electrolyte solution, there is a sharp fall in serum sodium and osmolarity caused by the leakage of irrigation fluid into the patients circulation. There is also a rise in central venous pressure and a fall of serum protein. There is a correlation between the fall of serum sodium and osmolarity and the rise of central venous pressure. Our results allow the conclusion that a restricted infusion programme with high sodium concentrations can be recommended. Depending on the patients serum protein, preoperative albumin solutions (20%) can be necessary to prevent a dangerous fall of oncotic pressure intraoperatively. The pathophysiology of the TUR syndrome and the importance of an adequate infusion therapy are discussed.
对24例接受经尿道前列腺切除术（TUR）的患者，每隔15分钟测量血清中的钠、钾、钙、镁、渗透压和蛋白质。根据电解质溶液的成分，灌洗液漏入患者循环系统会导致血清钠和渗透压急剧下降。同时中心静脉压升高，血清蛋白降低。血清钠和渗透压的下降与中心静脉压的升高之间存在相关性。我们的结果表明，可以推荐采用高钠浓度的限制性输液方案。根据患者的血清蛋白情况，术前可能需要使用白蛋白溶液（20%）以防止术中胶体渗透压危险下降。文中讨论了TUR综合征的病理生理学以及适当输液治疗的重要性。
