發(fā)布時(shí)間：2019-07-09 13:57

【摘要】：目的:研究乙醇標(biāo)記法監(jiān)測在前列腺汽化術(shù)中的安全性和可行性,探討呼出氣乙醇濃度與灌注液吸收量之間的關(guān)系和術(shù)中進(jìn)行灌注液吸收量監(jiān)測的必要性。方法:隨機(jī)選擇兩組各30例符合標(biāo)準(zhǔn)的前列腺增生患者,一組行前列腺等離子電切術(shù),一組行1470半導(dǎo)體激光前列腺汽化切除術(shù),在手術(shù)中使用含有1%濃度乙醇等滲鹽水作為灌注液,在手術(shù)開始及整個(gè)手術(shù)過程中使用酒精檢測儀每隔10分鐘測定呼氣末乙醇濃度,監(jiān)測呼吸中乙醇濃度后根據(jù)Hahn公式將呼氣乙醇濃度轉(zhuǎn)換為血液乙醇濃度,評(píng)估手術(shù)中灌注液吸收量,在術(shù)前手術(shù)30分鐘及手術(shù)結(jié)束時(shí)測定HB、HCT、血K+、NA+、CL+、PH及二氧化碳結(jié)合力,評(píng)估是否有液體吸收引起上述參數(shù)的改變。并且術(shù)中監(jiān)測患者TURS發(fā)生情況和有無乙醇沖洗液吸收副反應(yīng)發(fā)生。結(jié)果:60例前列腺增生手術(shù)患者術(shù)中接受乙醇濃度測定,術(shù)中監(jiān)測未發(fā)現(xiàn)因帶有乙醇的沖洗液吸收后出現(xiàn)副反應(yīng),未誘發(fā)過敏及心血管和肺部疾病發(fā)生,乙醇標(biāo)記法監(jiān)測在前列腺增生術(shù)中是安全可行的。通過乙醇濃度監(jiān)測在前列腺等離子電切患者中有21例測出乙醇濃度,并根據(jù)根據(jù)Hahn公式將乙醇濃度轉(zhuǎn)換后測出等離子電切中沖洗液吸收量約48.6-2650ml,術(shù)中2例患者出現(xiàn)了TURS予以及時(shí)糾正。而接受1470半導(dǎo)體激光手術(shù)患者中未監(jiān)測到乙醇吸收。結(jié)論:乙醇標(biāo)記法監(jiān)測在臨床中運(yùn)用具有安全性和可行性,在沖洗液中加入一定濃度的乙醇,沖洗液通過吸收入血后通過循環(huán)在呼吸終末成功監(jiān)測到了乙醇濃度,并通過Hahn公式我們可將其轉(zhuǎn)換評(píng)估灌注液吸收量。1470nm半導(dǎo)體激光具有良好的組織消融和止血效果,術(shù)中灌注液吸收少,等離子電切相比較監(jiān)測到一定量水吸收,但由于個(gè)體差異及患者綜合因素,具體吸收量達(dá)到多少可以出現(xiàn)TURS還需要大量病例標(biāo)本去研究。但前列腺增生病人中高危病人較多,心肺功能下降,我們將使用乙醇標(biāo)記法定量監(jiān)測術(shù)中可能存在灌洗液吸收,以期及早發(fā)現(xiàn)灌洗液的吸收量對(duì)心肺造成的不良影響,及時(shí)終止手術(shù)或積極治療,可以有效降低病人圍術(shù)期風(fēng)險(xiǎn)。
[Abstract]:Objective: to study the safety and feasibility of ethanol labeling in prostate vaporization, to explore the relationship between the concentration of ethanol exhaled and the absorption of perfusion fluid, and the necessity of monitoring the absorption of infusion fluid during operation. Methods: 30 patients with benign prostatic hyperplasia (BPH) in each group were randomly selected. One group underwent plasma resection of prostate and the other group underwent 1470 semiconductor laser vaporization of prostate. Saline containing 1% ethanol was used as perfusion solution during the operation. Alcohol detector was used to measure the concentration of ethanol every 10 minutes at the beginning of the operation and during the whole operation. After monitoring the concentration of ethanol in respiration, the concentration of ethanol in breath was converted into blood ethanol concentration according to Hahn formula, the absorption of perfusion fluid during operation was evaluated, the binding capacity of K, NA, CL, PH and carbon dioxide in HB,HCT, blood was measured 30 minutes before operation and at the end of operation, and the changes of the above parameters caused by liquid absorption were evaluated. The occurrence of TURS and the occurrence of side effects of ethanol flushing fluid absorption were monitored during operation. Results: the concentration of ethanol was measured during operation in 60 patients with benign prostatic hyperplasia (BPH). No side effects were found after the absorption of flushing fluid with ethanol, and no allergy and cardiovascular and pulmonary diseases were induced. Ethanol labeling was safe and feasible in benign prostatic hyperplasia (BPH). The ethanol concentration was measured in 21 patients with prostatectomy by ethanol concentration monitoring. According to Hahn formula, the absorption of flushing fluid in plasma electroresection was measured about 48.6 鈮，

本文編號(hào)：2512190