经尿道前列腺电切术患者术前左室舒张功能减退与术后血管外肺水增多的关系

Relationship between declined preoperative left ventricular diastolic function and increased postoperative extravascular lung water in patients undergoing transurethral resection of prostate

目的评价经尿道前列腺电切术(TURP)患者术前左室舒张功能减退与术后血管外肺水(EVLW)增多的关系。方法择期全麻下行TURP的患者116例,年龄55~90岁,ASA分级Ⅰ~Ⅲ级,BMI≤30 kg/m^(2),术前无EVLW增多。于出PACU前行肺超声检查,并进行肺超声评分,将肺超声评分≥20分定义为EVLW增多。记录术后EVLW增多的发生情况,按照是否发生EVLW增多分为EVLW增多组和非EVLW增多组。采用logistic多因素回归分析筛选术后EVLW增多的危险因素。结果logistic多因素回归分析结果显示,术前左室舒张功能减退是术后EVLW增多的独立危险因素(P<0.05)。结论术前左室舒张功能减退是TURP患者术后EVLW增多的独立危险因素。

Objective To evaluate the relationship between declined preoperative left ventricular diastolic function and postoperative increased extravascular lung water(EVLW)in the patients undergoing transurethral resection of the prostate(TURP).Methods A total of 116 patients,aged 55-90 yr,of American Society of Anesthesiologists physical statusⅠ-Ⅲ,with body mass index of≤30 kg/m^(2),undergoing elective TURP under general anesthesia,without increased EVLW before surgery,were included in the study.Lung ultrasound examination was performed and lung ultrasound scores were assessed before leaving PACU.Increased EVLW was defined as lung ultrasound score≥20.The occurrence of increased EVLW after operation was recorded,and patients were divided into increased EVLW group and non-increased EVLW group according to whether increased EVLW occurred.Multivariate logistic regression analysis was used to identify the risk factors for postoperative increased EVLW.Results The results of multivariate logistic regression analysis showed that declined preoperative left ventricular diastolic function was an independent risk factor for postoperative increased EVLW(P<0.05).Conclusions Declined preoperative left ventricular diastolic function is an independent risk factor for postoperative increased EVLW in the patients undergoing TURP.