Hahn R G, Nilsson A, Farahmand B Y, Ekengren J, Persson P G
Department of Anesthesia, Stockholm South Hospital, Sweden.
Epidemiology. 1996 Jan;7(1):93-5. doi: 10.1097/00001648-199601000-00016.
We studied the association between the operative course of transurethral resection of the prostate (TURP) and the morbidity of acute myocardial infarction (AMI) in a cohort comprising 846 patients who underwent this operation between 1983 and 1992. Up to the end of 1993, a total of 69 patients had developed AMI, of which 10 patients had a reinfarction. The relative risk associated with absorption of 500 ml or more of the irrigating medium during surgery was 1.6 [95% confidence interval (CI) = 0.9-3.0] for a first-time AMI after TURP, 6.1 (95% CI = 1.8-20.7) for a reinfarction, and 2.2 (95% CI = 1.3-3.9) for a first-time or a reinfarction combined. A blood loss of 275 ml or more was associated with a decreased relative risk (RR = 0.4; 95% CI = 0.2-0.8) of a first-time AMI after TURP. Patients who lost less than 275 ml of blood and absorbed 500 ml or more of irrigating fluid during surgery had 4.4 times the risk of having an acute myocardial infarction (RR = 4.4; 95% CI = 1.7-11.8). These results appear to indicate that the operative course of TURP is important to the development of AMI over an extended period of time.
我们研究了1983年至1992年间接受经尿道前列腺切除术（TURP）的846例患者队列中，该手术过程与急性心肌梗死（AMI）发病率之间的关联。截至1993年底，共有69例患者发生AMI，其中10例再次梗死。TURP术后首次发生AMI时，术中吸收500毫升或更多灌洗液相关的相对风险为1.6 [95%置信区间（CI）= 0.9 - 3.0]，再次梗死时为6.1（95% CI = 1.8 - 20.7），首次或再次梗死合并时为2.2（95% CI = 1.3 - 3.9）。失血275毫升或更多与TURP术后首次发生AMI的相对风险降低相关（RR = 0.4；95% CI = 0.2 - 0.8）。术中失血少于275毫升且吸收500毫升或更多灌洗液的患者发生急性心肌梗死的风险是其他人的4.4倍（RR = 4.4；95% CI = 1.7 - 11.8）。这些结果似乎表明，TURP的手术过程对较长时间内AMI的发生发展很重要。
