肺切除术后并发房颤的发病因素

Clinical characteristics of atrial fibrillation (AF) after lung resection

目的 :探讨肺切除术后并发房颤 (AF)的发病因素 ,提高诊治水平。方法 :回顾性分析 1988年至 1997年间连续 6 48例肺切除术的临床资料。结果 :术后并发AF 2 1例。年老 ,术前伴有 2种以上并存症 ,术中低血压及全肺切除 (尤其是心包内处理肺血管 )术式是术后并发AF的高危因素 (P <0 0 0 1) ;心肌缺氧是并发AF的重要原因。致命性AF少见 ,2 1例经及时诊治均恢复窦性心律 ,无此并发症死亡。结论 :提高肺切除术后并发AF的认识 ,加强防治措施 。

Objective:This study is to probe the clinical characteristics of AF after lung resection and to increase the successful rate of surgical treatment.Method:The data was analyzed retrospectively on 648 consecutive patients undergoing lung resection from 1988 to 1997.Result:21 cases complicatied postoperative AF (3.2%).The risk factors of postoperative AF were age older than 60 years,preoperative coexist with two or more diseases(COPD,HP,DM,etc.)intraoperative hypotension and pneumonectomy (especially intrapericardial procedures).The anoxia was the direct factor.Fatal AF was rarely seen and after timely treatment AF usuelly disappeared.Conclusion:Awareness of postoperative AF and perioperative management may reduce the morbidity of postoperative AF. [