食管癌与贲门癌术后心律失常危险因素分析

Risk factors of postoperative arrhythmias in esophageal carcinoma and cardiac carcinoma patients

目的:探讨食管癌、贲门癌术后发生心律失常的危险因素。方法:对106例食管癌、贲门癌术后发生心律失常患者的临床资料进行多因素Logistic回归分析,判定年龄、术前心电图异常、术前有无合并症(高血压、冠心病、糖尿病、肺部疾患)、FEV1/FVC%、MVV%、术前血钾、手术方式、手术时间等因素与术后发生心律失常的相关强度,推测可能导致术后心律失常发生的危险因素。结果:患者术前合并高血压、冠心病、肺部疾患及术前心电图异常、FEV1/FVC%<70%、术前血钾<4.0 mmol/L 6个因素与术后心律失常发生有显著相关性。结论:术前积极治疗心肺部合并症、术前心电图异常者进行针对性处理及术后重点心电监护、术前改善低肺功能、术前适当补钾均可预防和减少术后心律失常的发生。

Objective： To analyze the risk factors of postoperative arrhymias in esophageal carcinoma and cardiac carcinoma patients. Methods： 106 patients with postoperative arrhythmias in 630 cases after esophagectomy and cardiectomy were studied. Age, pre-operative abnormal ECG; pre-operative complications such as hypertention, coronary heart disease, diabetes, lung diseases, FEV1/FVC〈70%, pre-operative kalemia less than 4.0 mmol/L, the operative style, duration of operation, compared by Logistic Regression analysis. Results： The risk factors of postoperative arrhythmias included pre-operative complications such as hypertention, coronary heart disease, lung diseases, FEV1/FVC〈70%, pre-operative abnormal ECG and pre-operative kalemia less than 4. 0 mmol/L. Conclusion： To prevent the occurrence of postoper- ative arrhythmias, active treatment cardiopulmonary complications, improvement of pre-operative cardiopulmonary function, pre-operative proger complementary of kalemia are neccessary.