高危患者在血管外科手术前行冠状动脉重建术之利弊综述  

作　　者：Miklos D. Kertai 肖洁(译) 王祥瑞(校) 

机构地区：[1]Department of Cardiothoracic Anaesthesia, Semmelweis University, Budapest, Hungary [2]Department of Anesthesia, Harefield Hospital, London, UK [3]不详

出　　处：《麻醉与镇痛》2009年第1期1-9,共9页Anesthesia & Analgesia

摘　　要：血管外科手术患者如合并有冠状动脉疾病，发生心血管并发症的风险将增加。手术前心血管功能评估有助于发现需要进行冠状动脉造影的高危患者，并随后进行冠状动脉重建术，以达到改善围手术期甚至长期心血管转归的目的。但与药物治疗相比，冠状动脉重建手术的适应证和减少心血管并发症的有效性仍存在争议。本文通过分析已发表的文献，探讨与保守的药物治疗相比，手术前行血管重建术在择期血管手术中的作用。Patients undergoing vascular surgery are at increased risk for cardiac complications related to the presence of underlying coronary artery disease. Preoperative cardiac evaluation may help to identify high-risk patients in whom coronary angiography may be planned with subsequent coronary revasoalarization for the purpose of improving perioperative and long-term cardiac outcomes. However, the indications and efficacy for type of revascularization for the reduction of cardiac complications compared to medical therapy has been controversial. My aim in this review is to summarize the role of preoperative revascularization compared to conservative medical therapy before elective vascular surgery using current evidence from oublished studies.

关 键 词：冠状动脉重建术 血管外科 高危患者 手术前 心血管并发症 综述 冠状动脉疾病 外科手术患者 

分 类 号：R654.2[医药卫生—外科学] R654.3[医药卫生—临床医学]