摘要
目的探讨老年患者行经尿道前列腺电切术（TURP）后出现认知功能障碍的原因及处理方法。方法对2006年1月～2008年12月我院743例TURP手术进行回顾性总结,其中有17例术后4～48h内出现认知功能障碍,患者年龄67～86岁,既往均无明确神经系统疾病,其主要症状表现为焦虑、谵妄、躁狂、精神错乱、人格的改变及记忆力受损等。结果所有患者均未发现神经系统病变定位体征,8例急诊行头颅CT或MRI检查,未发现明显脑部病变,血液生化学检查结果显示2例患者合并轻度低钠血症。在根据病情给予安定或者氯丙嗪对症镇静治疗,同时纠正电解质紊乱,并给予耐心的精心护理后,全部病例经对症治疗后症状均消失。结论老年人行TURP术后出现认知功能障碍的原因尚不明确,主要与手术后创伤应激、老年性生理退变、手术过程麻醉药物的使用、术后电解质紊乱等多种因素有关。随着老龄人口比例的增长,将会有更多的老年男性需要接受TURP治疗,因此研究TURP术后认知功能障碍具有重要的医学及社会现实意义。
Objective To investigate the reason and treatment of postoperative cognitive dysfunction （ POCD） in elderly male patients after transurethral resection of prostate （TURP）. Methods from January 2006 to December 2008, 743 TURP operations were performed, and all the cases were reviewed retrospectively, of which 17 cases occurred cognitive dysfunction within 4 to 48 hours after operation, the age of the patients were from 67-86 years old without nervous system diseases previously. The main symptoms of the patients were anxiety, manic delirium, mental confusion, personality changes and loss of memory and so on. Results there were no located signs of nervous system lesions were found in all patients. 8 cases have undergone head CT or MR examination emergently, and no obvious brain lesions were found. Biochemical test results showed mild hyponatremia in 2 patients. The symptoms were disappeared in all patients after treatment by sedative medicine, correcting electrolyte imbalance, and meticulous care. Conclusion The reasons of cognitive dysfunction occurs after TURP are still unclear, mainly related to postoperative trauma stress, age-related physical degeneration, the using of narcotic drugs during operation and postoperative electrolyte imbalance, et al. With the aging population growth, the study of cognitive dysfunction after TURP has an important medical and social relevance.
作者
吴文起
庄小雪
赵子良
庄上英
曾国华
WU Wen-qi, ZHUANG Xiao-xue, ZHAO Zi-liang, ZHUANG Shang-ying, ZENG Guo-hua （1.Urology department, the First Affiliated Hospital of Guangzhou Medical College,Guangzhou 510230,China;2.Anesthesiology department, the First Affiliated Hospital of Guangzhou Medical College,Guangzhou 510230,China）
出处
《医学信息》
2010年第15期2885-2887,共3页
Journal of Medical Information
关键词
经尿道前列腺电切术
前列腺增生症
术后认知功能障碍
Transurethral resection of prostate
Benign prostatic hyperplasia
Postoperative cognitive dysfunction
