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【目的】探讨经尿道前列腺气化切除术对血压心率影响及心肌缺血损伤的程度。【方法】测定 46例经尿道前列腺气化切除术 (TUVP)围手术期血压心率、心肌酶、心电图等 ,以 18例耻骨上经膀胱前列腺摘除术作对照。【结果】二组心率、血压、中心静脉压、血糖、血钠的改变无差异。术后二组肌酸激酶 (CK)、心肌肌钙蛋白Ⅰ (cTnⅠ )较术前升高 ,肌酸激酶同工酶MB(CK MB)无明显改变 ,术后二组间CK、CK MB、cTnⅠ无差异。TUVP组术后cTnⅠ明显升高者cTnⅠ改变值与切除时间、前列腺的质量、心率、血压、中心静脉压、血糖、血钠的改变相关。【结论】无切穿前列腺包膜、大出血或TUR综合征的TUVP对血压心率影响及心肌缺血损伤程度轻微 ,前列腺组织气化破坏等可释放CK、CK MB。
【Objective】 To investigate the effect of transurethral resection of the prostate on blood pressure and heart rate and the degree of myocardial ischemic injury. 【Methods】 46 cases of transurethral vaporization of the prostate (TUVP) during perioperative blood pressure and heart rate, myocardial enzymes, ECG, 18 cases of suprapubic transvesical prostatectomy as a control. 【Results】 There was no difference in heart rate, blood pressure, central venous pressure, blood glucose and serum sodium between the two groups. The levels of creatine kinase (CK) and cardiac troponin Ⅰ (cTn Ⅰ) in the two groups after operation were significantly higher than those before operation, while there was no significant change in creatine kinase MB (CK MB) cTn Ⅰ no difference. The changes of cTnⅠ in patients with TUVP after cTn Ⅰ were significantly correlated with the time of resection, the quality of prostate, heart rate, blood pressure, central venous pressure, blood glucose and serum sodium. 【Conclusion】 TUVP without transection of prostatic capsule, hemorrhage or TUR syndrome has a slight influence on blood pressure and heart rate and myocardial ischemia, and can release CK and CK MB after vaporization and destruction of prostatic tissue.