肺切除术后发生房颤32例分析

Analysis of 32 cases of atrial fibrillation after lung resection

目的 探讨肺切除术后并发房颤的原因及处理 .方法 回顾性分析 1990 - 0 1/2 0 0 0 - 12连续 972例肺切除术后患者 (男 76 8,女 2 0 4 )的临床资料 ,其中肺恶性肿瘤 72 0例 ,良性疾病及外伤 2 5 2例 ,平均年龄 4 7.8岁 ,单纯肺叶切除包括肺楔性切除和肺段切除 70 8例 ,肺叶切除加支气管袖式成型术 14 8例 ,全肺切除 116例 .结果 术后并发房颤 32例(3.3% ) .高龄、术前肺功能较差或伴有其他疾病 (慢性阻塞性肺疾病、糖尿病、高血压 )、全肺切除 (尤其是心包内处理肺血管 )术式、术中低血压是术后并发房颤的高危因素 (P<0 .0 1) ;心肌缺氧是并发房颤的重要原因 .致命性房颤少见 ,及时治疗均可恢复窦性心律 .结论 提高肺切除后并发房颤的认识 ,加强防治措施 ,可把此并发症的危险性减至最低限度 .

AIM To investigate the cause and treatment of atrial fibrillation after lung resection. METHODS 972 consecutive patients (male 768, female 204) undergoing lung resection from Jan. 1990 to Dec. 2000 were analyzed retrospectively. In all of the patients, 720 cases were diognosed as suffering from malignant lung tumors, and 252 cases benign lung diseases and trauma, with the mean age of 47.8. The single lung lobectomy including lung wedge resection and seg mentectomy was performed onn 708 cases,lobectomy and sleeve resection on 148 cases, and pneumonectomy on 116 cases. RESULTS 32 cases complicated postoperative atrial fibrillation (3.3%). Older age, poor lung function, preoperative association with other dieases (COPD, DM,HP), pneumonectomy (especially intrapericardial procedures), intraoperative hypotension were risk factors of postoperative atrial fibrillation. Anoxia was the direct factor. Fatal atrial fibrillation was rarely seen and under timely treatment, atrial fibrillation usually disappeared. CONCLUSION Awareness of postoperative atrial fibrillation and perioperative management may reduce the morbidity of postoperative atrial fibrillation.