Prevent Effect Of 6% Hydroxyethl Starch 130/0.4 On Transurethral Resection Of Prostate Syndrome In The Patients Undergoing TURP

Transurethral resection of prostate(TURP) is a very common operation in modern urinary surgery.This surgical procedures requires the use of an irrigating fluid to dilate the operating field and to wash away debris and blood.A potential complication of such irrigation is systemic absorption of the fluid to the extent that overt symptoms are produced.The most serious complication is called transurethral resection of prostate syndrome(TURS),which occurs in between 1 and 8%literature reported.The prevention of TURS is very important,which consists of reduction of surgical time,lowering the fluid bag,low-pressure irrigation,usage of hypertonic saline and new techniques.6% hydroxyethl starch 130/0.4 is the newest hetastarch,which has excellent volume efficacity and less side-effects.Using 6%hydroxyethl starch 130/0.4 to prevent transurethral resection of prostate syndrome hasn't been reported.This experiment tries to supply the gap.Objective To study the effects of 6%hydroxyethl starch(HES)130/0.4 on blood plasma osmotic pressure and electrolyte K⁺,Na⁺,CI^- in the patients undergoing TURP,and to evalucate its significance in preventing TURS.Methods Sixty elderly patients with symptomatic BPH without suspected cancer undergoing TURP were randomized into three groups respectively,HES 10ml·kg^-1group(groupâ… ,n=20,with transfusion of 10ml 6%HES 130/0.4 per kilogran weight in vein in forty-five minutes from the beginning of anesthesia),HES 5ml·kg^-1 group(groupâ…¡,n=20,with transfusion of 5ml 6%HES130/0.4 per kilogran weight in the same phase),latic Ring's solution group(groupâ…¢,n=20,without using HES,but lactic Ring's solution 10ml per kilogran weight in the same phase ),then all the patiens were transfused with lactic Ring's solution to maintain volume therapy.The venous blood samples were taken to measure the levels of electrolyte K⁺,Na⁺,Cl^-,Hct,Hb and plasma osmotic pressure before anesthesia,upon 30 mintues after the beginning of operation,upon completion of operation.Results The blood plasma osmotic pressure and the serum Na⁺ level were steady in HES groups,rather gradually descended in latic Ring's solution group during operaion.The serum K⁺ level in groupâ…¡andâ…¢gradually descended,rather rose at first and then descended in groupâ… .The serum Cl^- changed less in groupâ… than that in groupâ…¢.The Hct and Hb level gradually descended in all groups,and the compare between groups and within groups had no statistical meaning.The total venous fluid volume of groupâ…¡was less than that of groupâ…¢,and that of groupâ… was less than that of groupâ…¢.The systolic pressure and diastolic pressure were more steady in groupâ… than that in groupâ…¢.Conclusion HES 130/0.4 using in TURP is propitious to get steady hemodynamics and internal environment.It is valuable in preventing TURP syndrome.