贲门癌术后早期心律失常的诱发因素探讨  

Risk Factors of Postoperative Arrhythmia After Cardiac Carcinoma

作　　者：许怀宏[1] 费苛[1] 张立凡[1] 唐健雄[1] 黄磊[1] 任玮[1] 

机构地区：[1]华东医院外科,上海200040

出　　处：《中国临床医学》2001年第3期222-223,共2页Chinese Journal of Clinical Medicine

摘　　要：目的 :探讨贲门癌根治术后心律失常的诱发因素。方法 :将我院 1987～ 1998年收治的贲门癌术后发生心律失常的 5 6例资料 ,与按 1∶2比例随机抽取同期贲门癌术后未发生心律失常的 112例资料作对照 ,用 χ2 检验及Logistic回归分析两组动脉血气监测结果、血清电解质变化情况、术前血液流变学、术前是否存在高血压史及心肌缺血、年龄、手术方式及术后是否应用有效镇痛等诸因素与术后心律失常发生的关系。结果 :术后低氧血症、术后低钾血症、术前全血粘度增高、术前有高血压史、心肌缺血史、经胸 (包括胸腹联合切口 )、术后疼痛因素与心律失常发生有显著相关性。结论 :为预防术后心律失常的发生 ,术前应重视对患者的心血管并发症治疗及改善血液流变学特性 ,术后要加强监测 ,及时纠正低氧血症、补钾 。Objective: To analyze the risky factors of p ostoperative arrhythmia in cardiac carcinoma patients.Methods: 56 cases with arrhythmia after radical resection of carcinoma were compared with 112 cases randomly without arrhythmia. All cases were inpatients of surgery department during 1987～1998. χ 2 test and Logistic Regression were used to analyze risk fa ctors of postoperative arrhythmia, including arterial oxygen tension of blood ga ses, serum electrolytes, preoperative hemorheology, history of hypertension and myocardial ischemia, major mode of surgery, eqidural analgesia and pat ient's age in two groups. Results: The risk factors of postoper ative arrhythmia included postoperative hypoxemia, postoperative hypokalemia, increased pr eoperative blood viscosity, incision at chest, histories of hyper tension or myocardial ischemia, taken eqidural analgesia after operation. Conclusion: To prevent the occurrence postoperative arrhythmia, cardiovascular complications and increased blood viscosity should be managed before the operation, monitoring int ensively, redressing hypoxemia and hypokalemia promptly, relieving pain effectiv ely should be done after operation.

关 键 词：贲门癌 心律失常 高危因素 手术后 

分 类 号：R735.2[医药卫生—肿瘤] R541.7[医药卫生—临床医学]