胸部肿瘤手术麻醉期间心律失常原因及处理

The Causes and Management of Arrhythmias During Anesthetic Period in Thoracic Tumor Surgery

目的通过观察分析2 485例胸科手术患者麻醉期间心律失常的发生情况,探讨胸科手术麻醉期间心律失常的发生原因及处理原则。方法麻醉期间采用胸前Ⅰ导联或标准Ⅱ导联连续监测ECG。记录心律失常的发生时间、类型、治疗措施及效果。结果麻醉中共发生各类心律失常2 386例(96.02%),严重心律失常827例(33.28%),经及时处理,绝大多数均很快纠正。结果显示胸科手术麻醉期间易发生心律失常,主要原因包括全麻气管插管和拔管反应、手术过程中操作刺激、单肺通气时间过长、术前合并心肺疾病、术前心电图异常、高龄等,麻醉期间应予重视。结论胸科肿瘤手术麻醉期间心律失常发生率高,术前要进行充分准备,术中要严密监测,以降低围术期并发症和死亡率。

Objective To summarize the causes and treatment of arrhythmias during the anesthetic period in thoracic tumor surgery. Methods To use the electrocardio graphic monitoring system to carry out continuous electrocardio graphic monitoring in the period of perioperativethoracotomy and to observe the rhythms and rates of the hearts. Results 2485 patients undergoing thoracic tumor surgery were included for a retrospective analyses. 96.02% of the patients were complicated by arrhythmia. With timely treatment, the arrhythmias were controlled almost in all patients. The causes of arrhythmias during anesthesia mainly were endotracheal intubation and extubation responses, operative stimulation, hypoxia and （or） retention of carbon dioxide, heart and lung diseases, elderly, abnormal ECG before operation. Conclusions It is necessary for the patients in the period of perioperative-anesthesia to carry out continuous ECG monitoring.