TUVP术中血糖CVP监测的临床意义.docVIP

TUVP术中血糖和中心静脉压监测的临床意义 敖翔 陆诚 段宏伟 姜波 （上海市南汇区中心医院麻醉科，上海 201300） 摘要 目的：探讨经尿道前列腺电汽化术（TUVP）中血糖（BG）和中心静脉压(CVP)的变化。方法：对112例TUVP患者资料进行回顾性分析并比较其麻醉前、术中30 min以及术毕的BG、CVP等。 结果：术中30 min、术毕的BG和CVP值与麻醉前相比均有显著升高（P0.05）,但术毕与术中30 min相比其BG和CVP的值无明显改变（P0.05）。结论：与经尿道前列腺电切除术（TURP）相比，TUVP能减少灌洗液吸收，但仍有发生经尿道电切综合征（TURS）之危险，密切监测BG、CVP及患者术中反应可降低TURS的发生率。 关键词 经尿道前列腺电汽化术; 经尿道前列腺电切除术; 血糖; 中心静脉压; 监测 The Clinical Significance of Monitoring Blood Glucose and central venous pressure during TUVP Ao Xiang Lu Cheng Duan Hongwei ，et al． （Department f Anesthesiology, Nanhui Central Hospital ,Shanghai 201300） Abstract ObjectiveTo summarize the change of blood glucose (BG) and central venous pressure (CVP) during transurethral electrovaporization of the prostate (TUVP). Methods: The clinical data of 112 patients undergoing TUVP were reviewed . The values of BG and CVP before anaesthesia , 30 min during operation and after surgery were compared . Results: The BG , CVP increased significantly during and after operation compared with those before anaesthesia（P0.05）.Compared with those at 30 min during operation , BG and CVP were not significantly changed after operation (P0.05). Conclusion: Although TUVP can decrease absorption of irrigation solution,the risk of TURS present still.The incidence rate of TURS could be reduced by keep close watch over patients and BG, CVP level. Key Words Transurethral vaporization of the prostate Transurethral electroresection of the prostate Blood glucose Central venous pressure Monitor 良性前列腺增生症（benign prostatic hyperplasia,BPH）好发于老年男性，是泌尿外科最常见的疾病之一。目前治疗前列腺增生最常用的手术方法有耻骨上经膀胱前列腺摘除术(subrapubical transvesical prostatectomy ,SPP)、经尿道前列腺电切除术（transurethral electroresection of the prostate,TURP）、经尿道前列腺电汽化术（transurethral vaporization of the prostate ,TUVP）。SPP存在创伤大、术后恢复时间长、并发症多等缺点；传统的TURP易导致经尿道电切综合征(transurethral resection syndrome,TURS)的发生；随着TUVP技术的发展和推广，手术过程中TURS的发生率明显减少。我院2004～2005年行TUVP 112例，手术中对BG和CVP进行常规监测，有1例发生TURS，13例有TURS先兆，现对其临床资料作回顾性分析，报告如下。 1 资料与方法 1