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心血管病人非心脏手术时围手术期处理 附132例报告 |
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孟凌新 张秉钧
【摘 要】 目的 总结心血管病人非心脏手术围手术期管理体会。方法 1997年6月至1999年6月收治成人外科手术132例,其中高血压72例,心肌缺血58例,其它2 例。结果 72例高血压术中因血压剧烈升高而应用降压药物者31例次;因血压过低,应用血管活性药18 例次;术前应用抗高血压药物者和未用药者术中出现血压剧烈波动的例数分别是4例(4/17) 和19例(19/55)。出现心肌缺血12例。术后心肌梗死4例。术后死亡8例。结论 心血管病人实施非心脏手术时充分的术前准备非常必要。 【关键词】 心血管 非心脏手术 麻醉
Perioperative management of cardiovascular patients for noncardiac surge ry(report of 132 cases).
Meng Lingxin,Zhang Bingjun.Department of Anes thesiology,2nd Affiliated Hospital of China Medical University,Shenyang 110003
【Abstract】 Objective This article talked about the experience of managing patients with cardiovascul ar problems who underwent noncardiac surgery.Methods 132 patients who underwent operations in adult surgery of our hospital from June 1997 to June 1999.72 patients with hypertension,58 suffered from myocardial isc hemia,2 other cases.Results Antihypertension durgs were given due to blood pressure enhancing violently in 3 1 out of 72 hypertension patients and vasoactive drugs were given to 18 out of 7 2 hypertensive patients due to blood pressure reducing overlow.Comparing treated with untreated patients,the times of blood pressure fluctuating during operatio n were 4/17 and 19/55 respectively.12 cases appeared myocardial ischemia.4 cases occurred cardiac infarct postoperatively.8 cases dead.Conclusion It is important to do sufficient preoperative preparations.Cardiovascular patie nts for noncardiac surgery should be managed elaborately and inspected closely d uring operation. 【Key words】 Cardiaovascular Noncardiac surgery Anesthesia
手术病人围手术期死亡的主要原因多与老年合并心血管疾病的病人增加有关。目前,我 国 心血管病的发病率几乎与欧美发达国家相同。因此,如何降低心血管病人非心脏手术围手术 期的病死率是非常重要的。本文收集我院近两年来合并心血管病的成人手术132例,现就病 人情况、术中经过及死因分析报道如下。
1 临床资料 1.1 术前情况 132例中,男84例,女48例。年龄45~85岁,平均64.4岁,≥70岁的31例。其中:(1 ) 高血压72例,其中Ⅰ期高血压16例,Ⅱ期41例,Ⅲ期15例。其中17例病人术前应用了抗高血 压药物至术晨。(2)心肌缺血65例。有心绞痛发作史29例,仅心电图(ECG)表现有心肌缺血25 例, 有心肌梗死(MI)病史11例。(3)其它6例,其中扩[1] [2] [3] 下一页 上一个医学论文: 联合血管重建胰腺癌根治术 附7例报告 下一个医学论文: 乳腺叶状囊肉瘤的诊断与治疗
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