老年患者体能状况对手术后严重室性心律失常的影响  

Effect of physical performance on postoperative severe ventricular arrhythmia in elderly patients

作　　者：张军龙[1] 屠伟峰[2] 邢怡安 戴建强[2] 顾明露 李士通[1] 

机构地区：[1]上海市第一人民医院麻醉科,201620 [2]广州军区总医院麻醉科

出　　处：《中华老年心脑血管病杂志》2016年第10期1046-1048,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：江苏省自然科学基金(BK20151107)

摘　　要：目的探讨老年患者体能状况对围术期严重室性心律失常（HRVEB）的影响。方法连续择期非心脏手术的患者100例,其中男性59例,女性41例,年龄60~95（71.2±6.1）岁,采用Duke体力活动指数评估每例患者手术前14~20d的体能状况。根据体能状况分为3组：Ⅰ组22例,〈4代谢当量（metabolic equivalents,MET）;Ⅱ组40例,4~7 MET;Ⅲ组38例,〉7 MET。以三通道动态心电图监测每例患者手术前、术后1和2d的心电活动,记录HRVEB的发生情况。结果Ⅲ组患者手术后1d HRVEB发生率明显低于Ⅰ组、Ⅱ组（10.5%vs 36.4%和30.0%,P〈0.05）,手术后2d,HRVEB的发生率明显高于术后1d（31.6%vs 10.5%,P〈0.05）。结论 MET水平影响老年患者室性心律失常的发生,MET〉7的患者手术后早期阶段HRVEB发生率明显降低。Objective To study the effect of physical performance on perioperative severe ventricular arrhythmia in elderly patients.Methods One hundred elderly patients（59 males and 41females）aged 60-95（71.2±6.1）years scheduled for elective noncardiac surgery were divided into groupⅠ（n=22）with its functional capacity（FC）〈4metabolil equivalent（MET）,groupⅡ（n=40）with its FC=4-7MET,and groupⅢ（n=38）with its FC〉7 MET according to their physical performance on days 14-20 before operation assessed by Duke activity status index.The cardioelectric activity of each patient was monitored on days 1and 2after operation by dynamic ECG.The incidence of severe ventricular arrhythmia was recorded.Results The incidence of severe ventricular arrhythmia was significantly lower in group Ⅲ than in groupsⅠand Ⅱon day 1after operation and was significantly higher on day 2than on day 1after operation（10.5% vs36.4%,10.5%vs 30.0%,P〈0.05;31.6%vs 10.5%,P〈0.05）.Conclusion The MET can influence the incidence of ventricular arrhythmia in elderly patients and the incidence of early ventricular arrhythmia is significantly lower in patients with their MET〉7.

关 键 词：手术期间 心律失常 心性 手术后期间 心电描记术 便携式 体质 

分 类 号：R614[医药卫生—麻醉学]