高龄患者非心脏手术术中心血管并发症的临床观察

Clinical study of intraoperative cardiovascular complication in the patients of advanced age undergoing noncardiac surgeries

目的 探讨手术、麻醉等因素对高龄患者非心脏手术术中心血管并发症的影响。方法 根据不同的手术部位、手术类型及麻醉方式回顾性分析 313例高龄患者非心脏手术病人的临床资料。结果 在高龄患者非心脏手术中 ,发生术中心血管并发症的男性和女性之间无显著差别。冠心病患者非心脏手术术中心血管并发症明显多于非冠心病患者。泌尿系手术术中心血管并发症发病率明显高于其它部位。泌尿系中以前列腺手术发病率最高 ;腹部手术中以阑尾手术发病率最高 ;骨科手术中以股骨切开复位及人工股骨头置换术发病率最高。硬膜外麻醉术中心血管并发症多于全麻 ,以局麻术中心血管并发症为最少。结论 高龄患者行非心脏手术因不同的手术部位、手术类型及麻醉方式其术中心血管并发症发生率不同 ,术前合并冠心病是高龄患者非心脏手术术中心血管并发症增多的主要原因之一 ;有针对性地预测、预防和减少高龄患者非心脏手术术中心血管并发症 。

Objective To study the influences of different types of operation and methods of anesthesia on intraoperative cardiovascular complications of the patients of advanced age(80 years and over 80 years old) undergoing noncardiac surgeries.Methods Retrospective analyzed the clinical datas of 313 patients of the advanced age undergoing noncardiac surgeries.Results Male patients who suffered from intraoperative cardiovascular complication is no difference with female.The morbidity of intraoperative cardiovascular complication in patients of advanced age with coronary heart disease more higher than that of without coronary heart disease.The morbidity of intraoperative cardiovascular complication of operations on urologic system was obviously much more than that on other systems;The morbidity of prostatectomy operation is higher than other operation in urology system;The morbidity of vermix operation is much more than other operation in abdominal region;The morbidity of operation open reduction in femoral and replacement fermoral head is much more than other operation in department of orthopaedics.The morbidity of intraoperative cardiovascular complication in patients with spinal anesthesia is obviously much higher than that with general and local anesthesia.Conclusion The morbidity of intraoperative cardiovascular complication in patients of advanced age undergoing noncardiac surgery was diffenert with place of operation, types of operation and methods of anesthesia.The coronary heart disease is one of the risk factors for intraoperative cardiovascular complication in patients of advanced age undergoing noncardiac surgeries.Our study is helpful for percaution and decrease intraoperative cardiovascular complication in the patients of advanced age undergoing noncardiac surgeries.