Thông báo trường hợp hội chứng nội soi mức độ nặng sau nội soi cắt tuyến tiền liệt qua đường niệu đạo

Abstract

Transurethral resection of prostate (TURP) syndrome is a systemic complication of transurethral resection of the prostate. The incidence of TURP syndrome is 0.78% - 1.4%, caused by excessive absorption of electrolyte-free irrigation fluids. Because water absorbed into the circulation causes hyponatremia, organizational edema. This syndrome may potentially cause pulmonary edema, cerebral edema, cardiovascular collapse, and maybe death. We report the case of severe TURP syndrome after transurethral resection of prostate. TURP syndrome is manifested with acute pulmonary edema, respiratory failure. Severe hyponatremia (serum Na⁺ 112.6mmol/l, serum osmolality pressure 234mOsmol/kg, pH: 7.23, pO₂: 45mmHg, pCO₂: 44mmHg) was a major biochemical manifestation. We had managed emergency care for successful patients: CPAP-PSV Pro breathing through mask with PEEP +5cmH₂O, pressure support 8cmH₂O, FiO₂ 70% - 100%, 20mg furosemid intravenously, 150ml of 3% NaCl; 100ml natribicarbonate 8.4%. Conclusion: TURP syndrome is a life-threatening complication that appears during or after a surgery. With continuous patient monitoring symptoms, which can be diagnosed early and treated promptly.