不同麻醉方式对老年良性前列腺增生患者蓝激光前列腺汽化术围手术期循环及术后恢复的影响OA
Effects of different anesthesia methods on perioperative circulation and postoperative recovery in elderly patients with benign prostatic hyperplasia undergoing blue laser vaporization of the prostate
目的 探讨不同麻醉方式对老年良性前列腺增生(BPH)患者蓝激光前列腺汽化术围手术期循环及术后恢复的影响.方法 回顾性收集2022年7月至2025年6月于咸阳市中心医院行蓝激光前列腺汽化术的BPH患者的临床资料,依据麻醉方式分为全麻(GA)组、椎管内麻醉(SA)组和非插管全凭静脉麻醉(NIVA)组,分析比较3组患者的围手术期循环指标和术后恢复指标.结果 共纳入265例BPH患者,GA组85例,SA组100例,NIVA组80例.与NIVA、SA组相比,GA组患者麻醉诱导意识消失时平均动脉压显著降低,手术结束时心率降低更明显,且麻醉后监护室停留时间和术后恢复饮食时间较长,Steward苏醒评分较低(P<0.05).与GA、SA组相比,NIVA组患者术后首次下床活动时间较早,恢复饮食时间、肠道恢复排气时间、术后住院时间较短,住院费用和术后并发症发生率较低,术后1 d时QoR-15评分较高(P<0.05).结论 老年BPH患者蓝激光前列腺汽化术中,NIVA循环稳定性好,术后恢复快,并发症发生率低,可作为首选麻醉方法.
Objective To investigate the effects of different anesthesia methods on perioperative circulation and postoperative recovery in elderly patients with benign prostatic hyperplasia(BPH)undergoing blue laser vaporization of the prostate.Methods Clinical data of BPH patients who underwent blue laser prostate vaporization at Xianyang Central Hospital from July 2022 to June 2025 were retrospectively collected.Patients were divided into three groups according to anesthesia method:general anesthesia(GA)group,spinal anesthesia(SA)group,and non-intubated intravenous anesthesia(NIVA)group.Perioperative circulation indicators and postoperative recovery indicators were compared among the three groups.Results A total of 265 BPH patients were included,with 85 in the GA group,100 in the SA group,and 80 in the NIVA group.Compared with the NIVA and SA groups,the GA group exhibited significantly lower mean arterial pressure(MAP)at the time of unconsciousness during anesthesia induction,a more pronounced decrease in heart rate at the end of surgery,longer length of stay in the post-anesthesia care unit(PACU),longer time to postoperative diet recovery,and lower Steward recovery scores(P<0.05).Compared with the GA and SA groups,the NIVA group had earlier time to postoperative ambulation,shorter time to diet recovery,first flatus time and postoperative hospital stay,as well as lower hospitalization cost and incidence of postoperative complication,accompanied by higher QoR-15 scores on the first day ofter the operation(P<0.05).Conclusion For elderly BPH patients undergoing blue laser prostate vaporization,NIVA provides better hemodynamic stability,rapid postoperative recovery and lower incidence of complications,which can be selected as the preferred anesthetic method.
郝珍;王煜;王纯玉;凡振伟;刘国雄;杜泉;赵树立
咸阳市中心医院麻醉手术部(陕西 咸阳 712000)咸阳市中心医院麻醉手术部(陕西 咸阳 712000)咸阳市中心医院麻醉手术部(陕西 咸阳 712000)咸阳市中心医院泌尿外科(陕西 咸阳 712000)咸阳市中心医院泌尿外科(陕西 咸阳 712000)咸阳市中心医院泌尿外科(陕西 咸阳 712000)咸阳市中心医院麻醉手术部(陕西 咸阳 712000)
医药卫生
蓝激光麻醉良性前列腺增生血流动力学加速康复外科
Blue laserAnesthesiaBenign prostatic hyperplasiaHemodynamicsEnhanced recovery after surgery
《医学新知》 2026 (5)
527-533,7
陕西省重点研发计划一般项目(2023-YBSY-058)咸阳市重点研发计划项目(L2023-ZDYF-SF-058)
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