Casthely P, Ramanathan S, Chalon J, Turndorf H
J Urol. 1981 Mar;125(3):347-9. doi: 10.1016/s0022-5347(17)55032-6.
Thoracic impedance of 18 patients undergoing transurethral resection of the prostate was measured 15 minutes preoperatively, and 30 and 60 minutes after the start of the operation. Impedance variations were compared to variation in 1) cardiac output, 2) serum sodium osmolality and 3) alveolar-arterial oxygen tension difference. Thoracic impedance, initially 24.6 plus or minus 0.3, decreased to 23.8 plus or minus 0.5, 30 minutes after the onset of the operation (p less than 0.0005) and 22.9 plus or minus 0.5, 30 minutes later (p less than 0.01 from previous reading and 0.0005 from control). Patients in whom impedance had decreased 10 per cent or more from control values received 10 mg. furosemide intravenously 60 minutes after the onset of the operation. This therapy permitted the restoration of impedance values, cardiac output, alveolar-arterial oxygen tension difference and serum sodium osmolality to values statistically similar to those found in the 10 patients who had not sustained such precipitous decreases in impedance within 60 minutes. We believe that the measurement of thoracic impedance during transurethral prostatic surgery offers the most sensitive index of early water intoxication. Measurements can be obtained without delay in the operating room and, thus, permit immediate correction of the condition.
对18例接受经尿道前列腺切除术的患者，在术前15分钟以及手术开始后30分钟和60分钟测量其胸部阻抗。将阻抗变化与以下各项的变化进行比较：1）心输出量；2）血清钠渗透压；3）肺泡-动脉氧分压差。胸部阻抗最初为24.6±0.3，手术开始后30分钟降至23.8±0.5（p<0.0005），30分钟后降至22.9±0.5（与前一次读数相比p<0.01，与对照组相比p<0.0005）。阻抗较对照值降低10%或更多的患者，在手术开始后60分钟静脉注射10mg呋塞米。这种治疗使阻抗值、心输出量、肺泡-动脉氧分压差和血清钠渗透压恢复到与10例在60分钟内阻抗未急剧下降的患者中所测得的数值在统计学上相似的水平。我们认为，经尿道前列腺手术期间测量胸部阻抗可提供早期水中毒最敏感的指标。在手术室中可立即进行测量，从而能够对病情进行即时纠正。
