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目的:探讨高龄前列腺增生症(BPH)患者不同术式与术后心血管意外的关系,评估经尿道绿激光前列腺汽化术(PVP)对高危前列腺增生患者的安全性.方法:72例接受手术治疗的BPH患者,其中开放手术(OP)组34例,PVP组38例;分别检测患者手术前后血清内皮素(ET-1)的动态变化,并按有或无冠心病(CHD)分层比较.结果:合并有CHD的BPH患者血清ET-1水平比较:术前OP组与PVP组无统计学差异(t=0.777,P>0.05),术后1d,OP组较PVP组升高(t=2.823,P<0.01);术后2d,两组比较,仍有统计学差异(t=4.678,P<0.01);无CHD的BPH患者,术前OP组与PVP组无统计学差异(t=0.478,P>0.05),术后1d,OP组较PVP组升高(t=4.370,P<0.01);术后2d,两组比较,仍有统计学差异(t=2.614,P<0.05).结论:BPH患者手术后存在着血管内皮功能障碍,而血管内皮功能受损可能是术后发生心血管不良事件的原因之一,尤以合并CHD的高危患者为甚,PVP是较安全的一种前列腺手术方法,可能减少合并CHD的高危前列腺增生患者术后心血管不良事件的发生.
Objective: To investigate the relationship between different surgical procedures and postoperative cardiovascular accident in elderly patients with benign prostatic hyperplasia (BPH) and to evaluate the safety of transurethral vapor laser photocoagulation (PVP) in patients with high-risk benign prostatic hyperplasia.Methods: 72 patients underwent surgical treatment Of patients with BPH, including 34 cases of open surgery (OP) group and 38 cases of PVP group. The changes of serum endothelin (ET-1) before and after operation were measured and compared with or without CHD. Results: The levels of ET-1 in BPH patients with CHD were significantly higher than those in PVP group (t = 0.777, P> 0.05) 2.823, P <0.01). There was still significant difference between the two groups at 2 days after operation (t = 4.678, P <0.01). There was no significant difference between preoperation BP and PVP in patients without BPH (t = 0.478, P> 0.05). On the 1st postoperative day, the OP group was significantly higher than the PVP group (t = 4.370, P <0.01) .Conclusion: There are vascular endothelial dysfunction after BPH surgery, and the impaired vascular endothelial function may be one of the causes of postoperative cardiovascular events, especially in high-risk patients with CHD. PVP is safer Prostate surgery method , May reduce the incidence of postoperative cardiovascular adverse events in high-risk BPH patients with CHD.