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[经尿道电切综合征]

[The TUR syndrome].

作者信息

Glogov S

出版信息

Khirurgiia (Sofiia). 1995;48(5):66-70.

PMID:8648972
Abstract

The incidence rate of transurethral resection (TUR) syndrome ranges from 1 to 7 percent, although the mild cases may reach up to 10.25 per cent. Irrigation using nonelectrolyte fluid is associated with absorption of the latter. The prompt penetration of more than one liter distilled water into the circulation becomes manifest with a diversity of cardiovascular and neurological symptoms. In the event of persisting hypotension with bradycardia, the acute forms of TUR syndrome may result in a fatal outcome. The essence of TUR syndrome necessitates the undertaking of competent treatment, carried out by a team of specialists, including, apart from urologist and anesthesiologist, an intensive care therapist, neurologist, cardiologist, ophthalmologist and laboratory physician. In addition to general supporting treatment, it is mandatory to combat hypotension, hyponatremia, hypoosmolality and anuria. Monitoring the amount of fluid being absorbed has important practical implications on the prophylaxis. For the purpose ethanol (1 percent) as indicator is added to the wash-out fluid. By its concentration in the air exhaled by the patient it is possible to measure the quantity of fluid intake. In the survey presented the detrimental effects of glycine--the commonest osmotically active constituent of the wash-out fluid--is also discussed.

摘要

经尿道切除术(TUR)综合征的发生率为1%至7%,不过轻度病例的发生率可能高达10.25%。使用非电解质液体进行冲洗会导致后者被吸收。超过一升的蒸馏水迅速进入循环会表现为多种心血管和神经症状。如果持续性低血压伴有心动过缓,TUR综合征的急性形式可能会导致致命后果。TUR综合征的本质需要由一组专家进行恰当治疗,这组专家除了泌尿科医生和麻醉师外,还包括重症监护治疗师、神经科医生、心脏病专家、眼科医生和检验医师。除了一般的支持性治疗外,必须对抗低血压、低钠血症、低渗透压和无尿。监测吸收的液体量对预防具有重要的实际意义。为此,将乙醇(1%)作为指示剂添加到冲洗液中。通过患者呼出气体中的乙醇浓度,可以测量液体摄入量。在本研究中,还讨论了冲洗液中最常见的渗透活性成分甘氨酸的有害影响。

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