围手术期高血压对胸部肿瘤患者术后心血管并发症的影响

Influence of Perioperative Hypertension on Postoperative Cardiovascular Complications in Chest Cancer Patients

背景与目的:围手术期高血压发病率逐年增多,高血压增加麻醉、手术的风险,影响患者的术后转归。本研究主要探讨围手术期高血压对胸部肿瘤患者术后心血管并发症的影响。方法:回顾性分析2005年8月至12月中山大学肿瘤防治中心胸科行开胸手术治疗的胸部肿瘤患者464例的临床资料。全组患者分为两组,其中围手术期高血压患者组152例,非高血压患者组312例。分析这两组患者的术后心血管并发症,然后进行卡方检验。结果:两组患者在年龄、性别、肿瘤种类、术前合并慢性疾病及术前心血管疾病分布相似(P>0.05)。围手术期高血压患者组术后心血管并发症54例,发生率为35.53%,其中心律失常41例,低血压8例,心衰3例,心肌缺血2例。围手术期非高血压患者组术后心血管并发症53例,发生率为16.99%,其中心律失常41例,低血压9例,心衰2例,心肌缺血1例。两组患者术后心血管并发症发生率的差异有统计学意义(P<0.05)。结论:围手术期高血压明显增加了胸部肿瘤患者开胸术后心血管并发症的发生率。

BACKGROUND ＆ OBJECTIVE： The incidence of perioperative hypertension is increasing in recent decades. Hypertension increases the risk of anaesthesia and surgical operation, and also affects the prognosis of patients apparently. This study was to investigate the influence of perioperative hypertension on postoperative cardiovascular complications in chest cancer patients. METHODS： Clinical data of 464 chest cancer patients, received thoracotomy in Cancer Center of Sun Yat-sen University between Aug. 2005 and Dec. 2005, were analyzed. Of the 464 patients, 152 had perioperative hypertension, and 312 did not. Postoperative cardiovascular complications of the 2 groups were compared with Chi-square test. RESULTS： The 2 groups had no significant differences in age, sex, tumor type, preoperative chronic disease, and preoperative cardiovascular disease （P〉0.05）. Postoperative cardiovascular complications were developed in 54 patients in perioperative hypertension group （including 41 cases of arrhythmia, 8 cases of hypotension, 3 cases of heart failure, and 2 cases of cardiac ischemia） and in 53 patients in perioperative non-hypertension group （including 41 cases of arrhythmia, 9 cases of hypotension, 2 cases of heart failure, and 1 case of cardiac ischemia）. The occurrence rate of postoperative cardiovascular complications was significantly higher in perioperative hypertension group than in perioperative non-hypertension group （35.53% vs. 16.99%, P〈0.05）. CONCLUSION： Perioperative hypertension obviously increases the incidence of postoperative cardiovascular complications in chest cancer patients after thoracotomy.