THE TRANSURETHRAL RESECTION SYNDROME

被引:78
作者
HAHN, RG
机构
[1] Department of Anaesthesiology, Huddinge University Hospital, Stockholm
关键词
GLYCINE; HYPONATREMIA; HYPOTENSION; RENAL FAILURE; TRANSURETHRAL RESECTION OF THE PROSTATE; COMPLICATIONS;
D O I
10.1111/j.1399-6576.1991.tb03348.x
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
The transurethral resection syndrome ("TUR syndrome") is caused by absorption of electrolyte-free irrigating fluid, and consists of symptoms from the circulatory and nervous systems. The clinical picture is inconsistent and the syndrome is easily confused with other acute disorders. Mild forms are common and often go undiagnosed, while severe forms of the TUR syndrome are rare and potentially life-threatening. The pathophysiology is complex but includes four mechanisms: circulation, distress from the rapid absorption of electrolyte-free irrigating fluid, adverse effects of glycine, dilution of the protein and electrolyte concentrations of the body fluids, and disturbance of renal function. The treatment of the TUR syndrome consists of general life support and in specific treatment directed towards hypotension, hyponatraemia and anuria. Methods to lower the uptake of irrigating fluid are widely used and probably reduce the incidence of the TUR syndrome. However, patient safety can be guaranteed only if the absorption is monitored. An irrigating fluid containing tracer amounts of ethanol can be used for this purpose. This permits the uptake of fluid to be indicated by measuring the concentration of ethanol in the patient's exhaled breath.
引用
收藏
页码:557 / 567
页数:11
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