新辅助化疗后患者围术期的心血管风险

Perioperative cardiovascular risk in patients with neoadjuvant chemotherapy

经大量临床试验证明新辅助化疗能提高乳腺癌患者的肿瘤切除率、有利于手术治疗,减少局部复发,为术后化疗提供依据。但常见的化疗药物都有严重的副作用,包括骨髓抑制以及致命性的心脏毒性。目的:本文旨在综述接受过新辅助化疗后患者围术期的心血管危险事件及其影响。内容:本文综述了乳癌新辅助化疗的各类药物及其心脏毒性,常用的观察化疗药物心脏毒性的监测指标和方法,新辅助化疗后的患者围术期心血管危险事件及心脏保护策略。趋向:临床麻醉中应重视化疗药物本身对心肌细胞的影响,合理用药和管理,减少化疗药物治疗后的患者围术期心血管危险事件发生。

A large number of clinical trials have confirmed that neoadjuvant chemotherapy can improve the rate of tumor resection in patients with breast cancer,it is beneficial to surgical treatment,reduce local recurrence,and provide the basis for postoperative chemotherapy.But common chemotherapy drugs have serious side effects,including bone marrow suppression and fatal cardiac toxicity.This study was designed to investigate the cardiovascular risk events and their effects in patients undergoing neoadjuvant chemotherapy.The content of this article is to review the breast cancer neoadjuvant chemotherapy drug cardiac toxicity,the commonly used monitoring indicators and methods to observe the cardiac toxicity of chemotherapeutic agents.To investigate the perioperative cardiovascular risk events and cardiac protection strategies in patients with neoadjuvant chemotherapy.clinical anesthesia should pay attention to the effect of chemotherapy drugs on myocardial cells,rational use and management,reduce the incidence of perioperative cardiovascular risk events in patients with chemotherapy drugs.