经尿道前列腺切除术-室颤-复苏-围术期心肌梗死

Perioperative myocardial infarction after TURP

报道71岁老年男性因前列腺增生实施经尿道前列腺切除术（transurethral prostatectomy，TURP）发生围术期心肌梗死（perioperative myocardial infarction，PMI）的诊疗过程。术中患者由于出现低血压、贫血、低体温、容量超负荷和低氧等引起长时间心肌缺血，最终诱发室颤并发生PMI。在给予除颤、强心、循环支持等药物治疗后，患者的病情得到稳定和改善。鉴于PMI是引起非心脏手术患者术后死亡的重要原因，对其诊断和处理应引起麻醉医师的重视。

This case report describes the management of a 71 -year-old man who suffered from hyperplasia of prostate gland and developed perioperative myocardial infarction （PMI） after transurethral prostatectomy （TURP）. Perioperative hypotension, anemia, hypoxemia, and hypothermia aggravated the patient＇s ischemia and volume overload, leading to ventricular fibrillation and PMI. After the management by defibrillation, cardiotonic agents and circulation supports, the patient was getting better and recovered to a stable condition. PMI is a major cause of morbidity and mortality in patients undergoing noncardiac surgery, so more attention should be paid to its diagnosis and management.