老年白内障合并心血管疾病患者围术期心率变异性研究  

Study on Heart Rate Variability of Senile Cataract Patients with Cardiovascular Disease during Perioperative Period

作　　者：孙中波[1] 梁健毅[2] 曾思明[2] 陈琦[2] 张琴[1] 覃晓波[1] 袁军[3] 

机构地区：[1]广西壮族自治区人民医院心电诊断科,南宁市530021 [2]广西壮族自治区人民医院眼科,南宁市530021 [3]广西壮族自治区人民医院心内科,南宁市530021

出　　处：《广西医学》2013年第1期27-28,34,共3页Guangxi Medical Journal

基　　金：广西医疗卫生科研课题(重2010042)

摘　　要：目的观察老年白内障合并心血管疾病患者围术期心率变异性(HRV)的变化,评估手术对老患者自主神经系统(ANS)功能的影响。方法 60岁以上白内障合并有心血管患者60例(60只眼),均在局部麻醉下行白内障囊外摘除联合人工晶状体植入手术;采用24 h动态心电图(DCG)检测HRV频域,观察患者手术前2 h、术中、术后2 h的低频功率(LF)、高频功率(HF)、LF/HF各频域指标的变化。结果术中LF、LF/HF均较术前低(P<0.05),术后2 h LF/HF低于术前(P<0.05),而术中与术后2 h之LF、HF、LF/HF各频域指标比较差异无统计学意义(P>0.05)。结论老年白内障合并心血管病患者行白内障囊外摘除联合人工晶状体植入手术时,术中和术后2 h对心脏自主神经系统功能影响较为严重,提示该时段可能是心血管疾病事件的易发时期,应给予高度的重视。Objective To observe the changes of heart rate variability（HRV） of senile cataract patients with cardiovascular disease during perioperative period, and to assess the influence of operation on autonomic nervous system （ANS） function of senile patients. Methods Sixty senile cataract patients （60 eyes） with cardiovascular disease aged over 60 were underwent cataract extraction with intraocular lens implantation under localized anesthesia. 24-hour dynamic electrocardiogram（DCG） was used to detect HRV frequency domain. The changes of low frequency（LF） ,high frequency （HF）, and LF/HF at 2 hours before operation,intraoperation, and 2 hours after operation were observed in the patients above. Results lntraoperative LF and LF/HF were significantly lower than perioperative ones （P 〈 0.05 ）. LF/HF at 2 hours after operation was significantly lower than pefioperative one （ P 〈 0.05 ）. There was no significant difference in LF, HF and LF/HF between intraoperation frequency domain indexes at 2 hours after operation and intraoperative ones （ P 〉 0.05）. Conclusion The heart ANS may have serious damage at perioperation and 2 hours after operation in senile cataract patients with cardiovascular disease undergoing cataract extraction with intraocular lens implantation. It suggests that the two periods mentioned above may have a higher morbidity of cardiovascular events than other periods, which should be valued.

关 键 词：白内障 心血管疾病 老年 围术期 动态心电图 心率变异性 

分 类 号：R776.1[医药卫生—眼科] R541.7[医药卫生—临床医学]