高龄患者开胸手术围术期心功能不全相关因素分析及处理体会  

The analysis of relative risk factors and perioperative management of acute heart failure after thoracic operation inelderly patients

作　　者：谈震东[1] 马海涛[1] 王秀云[1] 黄海涛[1] 翟光地[1] 

机构地区：[1]苏州大学附属第一医院心胸外科,江苏苏州215006

出　　处：《医学信息（手术学分册）》2007年第4期306-308,共3页Medical Information Operations Sciences Fascicule

摘　　要：目的通过高龄患者开胸术后围术期生命体征的临床观察及处理体会，探讨心功能不全等并发症的相关因素及防治措施。方法回顾性分析了2006年1月～2006年12月我科全麻下行开胸手术的151例高龄患者的临床资料。结果发生心功能不全9例，均发生于术后2～3d。术后第3d、第2d尿量较前一天明显增多。术前有合并症组术后血压较无合并症组高，心率快。年龄在75岁以上组心率较75岁以下组有增快趋势。结论开胸术后心功能不全与高龄、合并症、手术创伤、术后2～3d第三间隙液回吸收有关。对高龄患者应严格掌握手术适应证，充分术前准备，加强围手术期监护，适时应用利尿剂以防治心功能不全。Objective To study the risk factors and perioperative management of postoperative acute heart failure to elderly patients undergoing thoracic operation. Methods A total of 15l patients（ more than 70 years old） with thoracic operation were retrospcctively analyzed. Results Nine cases developed acute heart failure 2 to 3 days after surgery. The postoperation urine volume of the third day increased conspicuously compared with that of the second day, so did the volume of the second day compared with that of the first day. The mean blood pressure of the group with preoperative complications was higher, and the mean heart rate faster than that of the group without preoperative complications. The heart rate of the group over 75 tended to be faster than that of the younger group. Conclusions Acute heart failure is related to advanced age, comorbiditis, operative injury and the reabsorbtion of third space fluid to vascular 2 to 3 days after surgery. Operation should he well - prepared, applicability held rigidly, perioperative mornitoring enhanced and diuretic prescribed in time to manage acute heart failure of elderly patients.

关 键 词：高龄 开胸术 心功能不全 围手术期处理 

分 类 号：R654.2[医药卫生—外科学]