Ashton C M, Lahart C J, Wray N P
General Medicine Section, Veterans Administration Medical Center, Baylor College of Medicine, Houston, TX 77030.
J Am Geriatr Soc. 1989 Jul;37(7):614-8. doi: 10.1111/j.1532-5415.1989.tb01251.x.
We performed a prospective study of 250 men undergoing transurethral resection of the prostate to determine the incidence of perioperative myocardial infarction. The prevalence of coronary artery disease in the study group was 27%. Patients had measurement of total creatine kinase and its MB isoenzyme and electrocardiography preoperatively and on the first three postoperative days. Only one myocardial infarction was diagnosed, an incidence rate of 0.4%. The overall rate of serious post-operative complications was 3.6%. No deaths occurred during the operative hospitalization. We conclude that with transurethral resection perioperative myocardial infarction is a rare event despite the high prevalence of coronary artery disease in this surgical population. Routine postoperative surveillance with electrocardiograms and creatine kinase determinations in asymptomatic patients is not warranted.
我们对250例接受经尿道前列腺切除术的男性患者进行了一项前瞻性研究,以确定围手术期心肌梗死的发生率。研究组中冠状动脉疾病的患病率为27%。患者在术前及术后头三天均进行了总肌酸激酶及其MB同工酶的测定和心电图检查。仅诊断出1例心肌梗死,发生率为0.4%。术后严重并发症的总发生率为3.6%。手术住院期间无死亡病例。我们得出结论,尽管该手术人群中冠状动脉疾病的患病率较高,但经尿道前列腺切除术围手术期心肌梗死是一种罕见事件。对于无症状患者,术后进行常规心电图和肌酸激酶测定监测并无必要。