摘要
目的 :分析经尿道前列腺切除术 (TURP)病人围手术期低血压的特点、原因和相关因素 ,探讨预防、治疗低血压的具体方法。方法 :以 5 0例耻骨上前列腺摘除术病人为对照 ,观察实验组 130例 TURP病人围手术期动脉血压、心率、体温的动态变化及其反应 ,定量测定 TURP术中出血量和冲洗液吸收量。结果 :实验组病人出血量比对照组少 ,但实验组低血压发生率明显比对照组高。单因素分析表明 ,与 TURP病人低血压相关的变量有 :冲洗液吸收量、出血量、血钠下降、体温下降、前列腺切除重量、手术时间、血管容量获得和心血管疾病史 ;L ogistic回归分析提示 ,冲洗液吸收量大于 10 0 0 ml和体温下降大于 2 .0℃为低血压危险因素。结论 :TURP低血压发生率高是多种因素共同作用的结果 ,过量冲洗液吸收和体温快速下降是其两个重要原因 ;对于前列腺体积较大病人应采取必要的预防措施。
Objective: To identify the factors to transurethral resection of prostate(TURP) perioperative hypotension . Methods: The study group included 130 patients undergoing TURP. The control group included 50 patients who had suprapubic prostatectomy. Absorption of irrigation fluid was measured by determining the serum gentamycin level. Blood loss of TURP patients was calculated as the product of the irrigation fluid volume and hemoglobin concentration (determined with a photometer) divided by the preoperative blood hemoglobin concentration. Body temperature was recorded using a rectal probe. Serum electrolytes were determined pre and post op. Results: The blood loss in study group (380.2±98.3)ml was significantly less than in the control group ( 460.1 ±52.5)ml, P <0.05. However,the incidence of hypotension was significantly higher than the control group(28%,8%), P <0.01. Factors associated with TURP hypotension included volume of irrigation fluid absorption, blood loss, reduction in core temperature, decrease of serum sodium, operating time, prostate weight and volume and history of cardiovascular disease. After Logistic regression analysis, the most significant factors were excessive absorption of irrigation fluid and rapid central cooling. Conclusion: In our study TURP hypotension most closely correlated with volume of irrigation fluid absorbed and reduction in core temperature.
出处
《浙江大学学报（医学版）》
CAS
CSCD
2002年第3期206-209,共4页
Journal of Zhejiang University(Medical Sciences)
基金
浙江省卫生厅科研基金
