食管癌、贲门癌切除术后心律失常（附108例分析）  

POSTOPERATIVE ARRHYTHMIA AFTER RESECTION OF ESOPHAGEAL OR CARDIAC CARCINOMA:WITH ANALYSIS OF 108 CASES

作　　者：陈龙奇[1] 刘京波[1] 张明道[1] 平育敏[1] 

机构地区：[1]河北医学院第四医院胸外科,河北医学院第四医院心内科

出　　处：《中华肿瘤杂志》1994年第6期438-440,共3页Chinese Journal of Oncology

摘　　要：１９９１年９月～１９９２年６月，作者对４５３例行食管癌、贲门癌切除术的患者进行术后至少７２小时连续心电监护，发现心律失常１０８例，发生率为２３．８％。术后心律失常明显多见于术前心电图异常以及主动脉弓上吻合者，其最常见类型为窦性心动过速，占７２．２％，致死性心律失常罕见。８７．０％的心律失常发生于手术后２４小时内。术后心律失常的常见原因为手术创伤应激反应、心肺功能不全、低血容量及高热反应。经积极处理，心律失常多于术后４天内恢复。处理上首先应查明并尽可能去除病因，然后才是治疗问题。Abstract Between Sept.1991 and Jun.1992,a total of 453 cases with carcinomas of the esophagus orgastric cardia underwent surgical resection of cancer.In all patients,ECG was continuously moni-tored for at least 3 days after operation.There were 108 cases of postoperative arrhythmias,withan incidence of 23.8%,but 32.9% in patients with abnormal preoperative ECG,higher than thatwith normal preoperative ECG(21.9%)(P<0.05).The postoperative arrhythmia appeared morefrequently in the gastresophageal anastomosis above the aortic arch(35.0%)than in that below it(16.3%)(P<0.01).In 87.0% of arrhythmias appeared within 24 hours after the operation and 72.2%was sinus arrhythmia.The fatal arrhythmia was rarely seen.The common causes of postoperativearrhythmia were operative trauma and stress,respiratory insufficiency,heart failure,hypovolemia andhigh fever.After treatment in time,arrhythmias disappeared in 4 days.The emphasis is to findand get rid of the causes at first,then is the treatment of arrhythmia.

关 键 词：食管肿瘤 外科手术 胃肿瘤 并发症 心律失常 癌 

分 类 号：R735.06[医药卫生—肿瘤] R541.7[医药卫生—临床医学]