高龄急性心房扑动患者行开腹探查术的麻醉管理(附1例报告)

An anaesthesia report of an elderly patient with acute atrial flutter undergoing exploratory laparotomy

心房扑动是心房内折返回路引起的快速型心律失常,心室率甚至可超过150次/分,严重时会出现低血压、晕厥甚至休克。高龄患者发生急性心房扑动较为少见,可诱发心功能不全,甚至可导致死亡,麻醉管理困难且风险较大。本文报道1例80岁高龄急性心房扑动患者,行开腹探查术,并在术中成功电复律。患者术后心电监测显示窦性心律,转入ICU继续治疗13 d后,患者复查生化全项、血常规、血凝等指标未见明显异常,准予出院。

Atrial flutter(AFL)is a rapid arrhythmia caused by the refolding pathway in the atrial,with a ventricular rate of 150 beats per minute or more,and hypotension,syncope and even shock in severe cases.Acute atrial flutter in el⁃derly patients is rare,which can induce cardiac insufficiency,and even lead to death,and anesthesia management is diffi⁃cult and risky.This article reported that an 80-year-old patient with acute atrial flutter underwent exploratory laparotomy and was successfully electrical cardioversion during the operation.Postoperative ECG monitoring showed sinus rhythm,and the patient was transferred to ICU for continued treatment.After 13 days of treatment,the patient was discharged from the hospital after no significant abnormality was found in the biochemical complete items,blood routine,blood coagulation and other indicators.