围术期心肌缺血发生率的调查

Survey of the Perioperative Myocardial Ischemic Incidence

目的调查围术期心肌缺血的发生率、心肌缺血各年龄段的发病比例及心肌缺血在术中和术后的结局,为麻醉医师围术期心肌缺血的治疗和管理提供依据。方法从2006年我院6000例择期手术患者中筛选取446例心肌缺血的患者,观察他们心电图和心率血压变化及术后结局,用统计学方法评价围术期心肌缺血在各个年龄段的发病率及麻醉方法对心肌缺血患者循环指标的影响。结果6000例择期手术患者中有446例心肌缺血的患者,发病率为7.43%,各年龄段中,50岁以上心肌缺血发病者共有392例(87.9%),50岁以下有54例(12.1%);术后有48例(10.8%)因为术中循环指标不稳定及呼吸功能不全送入ICU病房治疗。结论50岁以上的患者围术期心肌缺血发病率高,合并高血压、糖尿病等并发症的比例大,全身麻醉对于此类心肌缺血患者术中循环指标影响大,因此术前认真评估,做好术前准备及围术期管理尤为重要。

Objective .To investigate the incidence of perioperative myocardial ischemia to give anesthesiologists support for dealing with the periopemtive myocardial isehemia. Methods 446 myocardial isehemie patients were selected from 6000 preoperative patients in SHENG JING Hospital of China Medical University. Their ECG, changes of eirculating parameters and the end-results were observed. The proportion of periopemtive myocardial isehemia at each age and the end-results of periopemtive myocardial ischemie patients were evaluated with statistical methods. Results There were 446 myocardial isehemie patients in 6000 preoperative patients; 392 myocardial isehemie patients were 50 years old or older, while 54 myocardial isehemie patients younger than 50 years old. 48 patients were sent to ICU ward because of circulatory parameters fluctuation or respiratory system insufficiency. Conclusion The periopemtive myocardial isehemia oceurred more frequently in the patients over 50 years old,with higher proportion of complicated high blood pressure and diabetes. Circulatory parameters such as BP and HR fluctuate more in general anesthesia in this group of patients. Therefore, it is of great importance to evaluate their preoperative condition earefully, give sufficient preoperative preparation and strict periopemtive management.