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目的:探讨合并缓慢型心律失常的BPH患者行经尿道前列腺等离子双极电切术(PKRP)围手术期的处理方法。方法:2006年5月～2010年5月我院行PKRP者89例,术前均明确BPH合并缓慢型心律失常。患者术前纠正基础疾病,有严重心动过缓者安装心脏起搏器;术中采取综合保温措施,控制冲洗液压力。对于前列腺体积>60ml者行前列腺通道成形术。结果:围手术期,23例出现心动过缓,14例出现心律失常,应用阿托品、异丙肾上腺素等药物治疗得到纠正,无一例发生阿-斯综合征及心律失常引起的并发症。结论:对于缓慢型心律失常患者,在PKRP术前合理准备、术中采取保温措施、控制冲洗液压力、缩短手术时间,可明显降低围手术期心血管事件的发生率。
Objective: To investigate the perioperative management of transurethral prostatectomy (PKRP) with BPH in patients with bradyarrhythmia. Methods: From May 2006 to May 2010, 89 patients with PKRP in our hospital were confirmed BPH complicated with arrhythmia before operation. Patients preoperative correction of underlying diseases, severe bradycardia were installed pacemakers; surgery to take an integrated insulation measures to control the irrigation fluid pressure. For prostate volume> 60ml were underwent prostate channeloplasty. Results: During the perioperative period, 23 cases had bradycardia and 14 cases had arrhythmia. The treatment with atropine and isoproterenol was corrected. No complications occurred due to Asperger’s syndrome or arrhythmia. Conclusion: For patients with bradyarrhythmia, preoperative preparation of PKRP, thermal insulation during operation, control of irrigation fluid pressure and shortening operation time can significantly reduce the incidence of perioperative cardiovascular events.