前立腺TUR手術中に肺水腫および心筋硬塞を併発した1例

A CASE WITH COMPLICATION OF PULMONARY EDEMA AND MYOCARDIAL INFARCTION IN THE COURSE OF OPERATION WITH TUR-P

はじめに

　高齢者および既往に心疾患，肺疾患を有する患者の麻酔，手術には予期せぬ危険が存在する。ことに人口の老齢化の進んでいるわが国では，泌尿器科領域における前立腺TUR施行症例が増加している。

　今回，われわれは既往に陳旧性前壁心筋硬塞をもつ前立腺肥大症の患者を，腰椎麻酔下に前立腺TURを施行したところ，術中に肺水腫および心筋硬塞（同部位再硬塞）を来した症例を経験したので，その発症因子と治療について，若干の考察を加え報告する。

TUR-P was done under spinal anesthesia, in a patient with obsolete myocardial infarction in the past illness who developed pulmonary edema and recurring infarction with TUR-reaction (water intoxi-cation) in the course of the operation. The etiological factors of the complications and treatments against them were described hereunder with some discussions.

The patient was a 75 years old male with a body weight of 40kg. The preoperative check ups reveraled no abnormal finding except for those detected with ECG on the infarction of the anterior wall of heart one year before the operation.