经尿道前列腺气化切除术对心肌酶及血压心率的影响

<etitle><Title>The Effects on the Myocardial Enzymes, Blood Pressure and Heart Rate of Transurethal Vaporization of the Prostate<eauthor><Author>WEN Xing-qiao, GAO Xin, QIU Jian-guang, CAI Yu-bin, KE Liang-song (Department of Urology, Third Affiliated H

【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 evaluate the effects on the blood pressure(BP), heart rate(HR) and myocardial ischemia damage of transurethal vaporization of the prostate(TUVP). Methods In 46 cases of TUVP serum CK, CK-MB, cTn Ⅰ, BP, HR, cardiovascular complications and eletrocadiograms were measured. Eighteen cases of suprapubic prostatectomy were measured as the control. Results The change of HR,BP,CVP,serum Na+,blood glucose had no difference between the two groups. The post-operative CK, cTn Ⅰ levels were higher than the pre-operative levels, the post-operative CK-MB level had no difference comparing to the pre-operative levels. There were no difference of the post-operative CK, CK-MB, cTn Ⅰ levels between the two groups. The change of cTn Ⅰ was correlated to the resection time, the reseted mass, the change of HR,BP,CVP,serum Na+,blood glucose in the patients with significant elevation of cTn Ⅰ in the TUVP group. Conclusions If there is no prostatic capsule perforation, large blood loss or TUR syndrome, the effects on the BP, HR and the myocardial ischemia damage of TUVP are very mild. Electrovaporization of the prostatic tissues may release CK, CK-MB to the circulation.<ekeyword><