经尿道电切综合征模型的建立和心功能评价
来源：医学论文发表——赛恩斯
作者：冯艳红作者单位：辽宁医学院附属第一医院泌尿外科，辽宁锦州121001
【摘要】目的以5%甘露醇冲洗液建立犬经尿道电切综合征(TURS)模型，探讨TURS对心功能影响。方法家犬8只，以100 mL/min速度静脉输入5%甘露醇冲洗液3 000 mL，建立犬TURS模型;于输液前和输液后10、20、30、60 min，测定心功能，血清钾、钠、氯浓度，心肌酶谱，心电图，并进行病理观察。结果心率、左室舒张期末内径、收缩期末内径在30 min时增加(P值均<0.05)，收缩压、舒张压、脉压和射血分数30 min时降低(P值均<0.05)。血清天冬氨酸转氨酶、乳酸脱氢酶、肌酸激酶和肌酸激酶同工酶在60 min时的变化无统计学意义(P>0.05)。TURS时心电图可有心律不齐和心肌缺血改变。病理观察示心肌纤维间充血和局部变性，肺脏水肿。结论TURS可引起心功能改变，并造成心肌损伤。发生TURS时心率和血压的改变出现较早，应足够重视，并及时的检测血清离子。
【关键词】经尿道电切综合征水中毒心功能心肌酶谱犬
Establishment of the Transurethral Prostate Resection Syndrome Model and the Evaluation on Cardiac Function
FENG Yanhong，JIANG Huamao，ZHANG Chunyang，ZHANG Datian，LIU Yan
Department of Ultrasound, the First Affiliated Hospital of Liaoning Medical University，Jinzhou 121001 China
Abstract : Objective To establish the transurethral prostate resection syndrome model in dogs and probe into the effects on cardiac function of the models of TURS. Methods We established animal models in eight dogs by intravenous injections of 3 000 mL 5% Mannitol at 100 mL/min. Cardiac function and electrocardiogram were examined before and after 10,20,30 and 60 minutes when serum dielectrics, myocardial enzymes were measured. Samples of the cardiac muscle and lung were taken out 60 minutes after the drug administration and were observed the histological changes. Results Heart rate, left ventricular end-diastolic dimension and left ventricular end-systolic dimension were increased 30 minutes after administration(P<0.05), systolic blood pressure, diastolic blood pressure pulse pressure and ejection fraction and shortening fraction but decreased in 30 minutes(P<0.01). The serum sodium, potassium and chloride levels were decreased at any time points, but the changes of myocardial enzymes were insignificantly in 60 minutes after
administration(P>0.05). There were such changes as anisorhythmia, myocardial ischemia in electrocardiogram. Pathological examination revealed hyperaemia among myocardial fibers cardiac muscle fibers, part apomorphosis and edema of lung. Conclusions TURS may cause changes on cardiac function and myocardial damage. It was earlier to change heart rate and blood pressure when TURS happened. It is essential to examine blood dielectric in transurethral prostatic resection.
Key words:transurethral prostate resection syndrome; water intoxication; cardiac function; myocardial enzymes; dogs
经尿道电切综合征(Transurethral prostate resection syndrome，TURS)是经尿道前列腺电切术的最严重并发症，为术中冲洗液快速、大量吸收所致的稀释性低钠血症和水中毒。本研究以5%甘露醇建立了犬TURS模型，并进行心功能评价。
1 材料和方法
1.1 实验动物
健康杂种犬8 只，雄性，体重10～15 kg，7～10 岁龄，由辽宁医学院实验动物中心提供。
