| 内腔镜手术智能监测系统在经尿道前列腺单极电切手术中应用的初步研究 |
| Alternative Title | Preliminary study on the application of endoscopic operation intelligent monitoring system in the ransurethral resection of prostate
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| 范宁 |
| Thesis Advisor | 王志平
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| 2015-05-06
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| Degree Grantor | 兰州大学
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| Place of Conferral | 兰州
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| Degree Name | 硕士
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| Keyword | 内腔镜
监测系统
经尿道前列腺电切术
冲洗液吸收
出血
经尿道电切综合征
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| Abstract | 内腔镜手术智能监测系统在经尿道前列腺电切手术中应用的初步研究
中文摘要
目的 评价内腔镜手术智能监测系统各测量模块及整机体外模拟冲洗液吸收和出血的准确性，并探讨其在TURP中的应用情况。
方法 选用不同标准容量的5%甘露醇冲洗液和血液进行重复性试验，使用单样本T检验比较实测值和标准值之间的差异，验证内腔镜手术智能监测系统的准确性；临床试验中观察了2014年3月至7月间28例TURP手术患者术中冲洗液的吸收和出血，详细记录了患者术前术后的各项监测指标，运用配对和独立样本T检验对试验结果进行了统计学分析。
结果 内腔镜手术智能监测系统对5%甘露醇冲洗液的吸收和血液的监测具有很高的准确性；临床28例患者TURP手术均获成功，术中平均液体吸收量为678.07±407.70ml，平均出血量为117.95±74.45ml。1例（3.6%）患者术中出现了TURS的先兆症状（胸闷、恶心）给予相应处理后缓解，其余患者无异常，无输血病例。患者术后的血氧饱和度、血红蛋白、红细胞比容及血清钠离子浓度较术前相比有所降低，差异具有统计学意义（P＜0.05），手术前后患者心率、平均动脉压、血清钾离子、血清氯离子及二氧化碳结合率的差异不具有统计学差异（P＞0.05）。手术时间大于60分钟的病例的冲洗液吸收量和出血量显著高于其他病例（P＜0.05），冲洗液吸收量大于1000ml的病例其血清钠离子浓度下降程度显著高于其他病例（P＜0.05）。
结论 内腔镜手术智能监测系统能够满足临床应用的需要，使用该系统可实现实时、准确地监测TURP术中的冲洗液吸收和出血并可以设置报警值以提醒手术医师；缩短手术时间有利于降低术中冲洗液的吸收和出血，针对手术时间大于60分钟和冲洗液吸收量大于1000ml的患者应加强其术中及术后的监测和护理；对出现疑似TURS症状的病例应及时给予干预措施以防止不良手术事件的发生。
关键词：内腔镜，监测系统，经尿道前列腺电切术，冲洗液吸收，出血，经尿道电切综合征 |
| Other Abstract | Preliminary study on the application of endoscopic operation intelligent monitoring system in the ransurethral resection of prostate
Abstract
Objective To evaluate the accuracy of each measurement module of endoscopic operation intelligent monitoring system and the whole simulation in vitro in monitoring irrigating fluid absorption and blood loss,and to explore its application in TURP.
Method Using different standard capacity of 5% mannitol solution and blood tested repeatability, a single sample T test was used to compare the difference between the standard value and the measured value, verifying the accuracy of endoscopic operation intelligent monitoring system; in clinical trial we observed the fluid absorption and blood loss of 28 patients who undergone TURP operation in 2014 March to July, taken a detailed record of the monitoring indicators in all the patients preoperativly and postoperativly, the paired and independent samples T test was used for statistical analysis of test results.
Results Monitoring endoscopic operation by intelligent monitoring system of 5% mannitol solution absorption and blood loss had very high accuracy; 28 clinical cases of patients with TURP operation were successful, the mean intraoperative fluid absorption was 678.07 + 407.70ml, the average amount of bleed loss was 117.95 + 74.45ml. One cases (3.6%) appeared premonitory symptoms of TURS (chest tightness, nausea) ,and had eased after given the corresponding treatment remission, the remaining patients had no abnormal, no case neesed blood transfusion. Postoperative oxygen saturation, hemoglobin, hematocrit and serum sodium concentration was lower than before the operation, with significant difference (P < 0.05), the patients’ heart rate, mean arterial blood pressure, serum potassium, serum chloride ions and carbon dioxide combining rate difference before and after surgery did not have statistical difference (P > 0.05). Cases in the group that operation time was more than 60 minutes of the cases of irrigating fluid absorption amount and the amount of bleeding was significantly higher than that in other cases (P < 0.05),cases in the group that absorption of irrigating fluid was greater than 1000ml of the serum sodium concentration decreased significantly higher than that in other cases (P < 0.05).
Conclusion The endoscopic operation intelligent monitoring system can meet the need of clinical application, the use of the system can realize real-time and accurate monito... |
| URL | 查看原文
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| Language | 中文
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| Document Type | 学位论文
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| Identifier | https://ir.lzu.edu.cn/handle/262010/222926
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| Collection | 学院待认领
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| Affiliation | 临床医学院
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Recommended Citation
GB/T 7714 |
范宁. 内腔镜手术智能监测系统在经尿道前列腺单极电切手术中应用的初步研究[D]. 兰州. 兰州大学,2015.
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