摘要
目的研究心血管疾患病人接受非心脏手术时,术中调控患者心率低于术前水平,对术后3d发生心肌缺血的影响.方法选择71例行腹部手术的患者,年龄55～78岁,随机分为对照组和实验组.对照组(n=36)术中维持心率于术前平均水平,实验组(n=35)较术前降低10%～20%,所有病人行术前1d、术中以及术后3dHolter监测,比较两组间心率、ST段变化情况.结果实验组心率术后和术前相比,差异无统计学意义(P>0.05),而对照组心率术后第1天、第2天较术前增快,且术后第1天高于实验组(P<0.05);对照组术后有20人(55.6%)发生心肌缺血,实验组术后有9人(27.3%),两组间心肌缺血的发生率差异有统计学意义(P<0.05).结论心血管疾患病人行非心脏手术,术中一定范围内降低心率,有利于稳定术后心率,减少术后心肌缺血的发生.
Objective To investigate the influence of controlling heart rates on postoperative myocardial ischemia in patients with cardiovascular disease during noncardiac surgery, especially in 3 days after surgery. Methods Eight-seven patients aged 55 - 78 yrs undergoing noncardiac surgery were devided into two groups at random： control group （group Ⅰ , n = 36） and management group （group Ⅱ , n = 35）. The heart rates of patients in management group were degraded 10% - 20% during operation than before operation. Holter was used to monitor all of the patients＇ heart rate and myocardial ischemia, during one day before operation, operation and 3 days after operation. The index of holter was recorded and compared. Results There was no significant difference between postoperative and preoperative in group Ⅱ （P 〉 0.05） , but significant difference in group Ⅰ and between group Ⅰ and group Ⅱ during the first postoperative day （P 〈 0.05）. 3 days affer operation, twenty patients in group I and five patients in group Ⅱ developed myocardial ischemia. There was significant difference between the two groups （P〈 0.05）. Conclusion Controlling heart rates of patients with cardiovascular disease during anesthesia can keep constant heart rates and show reduced incidence of postoperative myocardial ischemia.
出处
《昆明医学院学报》
2009年第7期116-120,共5页
Journal of Kunming Medical College
关键词
非心脏手术
心率
心肌缺血
Noncardiac surgery
Heart rate
Myocardial ischemia
