老年非心脏手术患者围手术期心脏不良事件的影响因素  

Influence factors of adverse cardic events in perioperative period of noncardiac surgery in elderly patients

作　　者：宋辉[1] 何平[1] 梁杰雄[1] 邵天松[1] 李洋[1] 贾明扬 SONG Hui;HE Ping;LIANG Jiexiong;SHAO Tiansong;LI Yang;JIA Mingyang(Department of General Surgery, Belting Anzhen Hospital, Capital Medical University, Beijing Institute of Heart ,Lung and Blood Vessel Diseases, Beijing 100029, Chin)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所普外科,100029

出　　处：《心肺血管病杂志》2018年第3期206-209,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:研究老年非心脏手术患者围手术期心脏不良事件的影响因素。方法:分析112例老年非心脏手术患者围术期的临床资料,分析与发生围手术期心脏不良事件相关的因素,比较有心脏不良事件组与无心脏不良事件组之间的差异。结果:术后42例(37.5%)发生心脏不良事件。与无不良事件组相比,发生心脏不良事件的患者多合并冠心病、行冠状动脉支架及旁路移植手术、合并心脏瓣膜病、存在心律失常、术前射血分数EF<50%、手术规模大、麻醉时间长、术前高敏C反应蛋白(hs-CRP)及B型利钠肽(BNP)增高(P<0.05)。结论:老年非心脏手术患者围手术期危险因素包括合并冠心病、行冠状动脉支架及旁路移植手术、合并心脏瓣膜病、存在心律失常、术前EF值<50%以及手术规模大、麻醉时间长、术前hs-CRP和BNP增高,其中术前hs-CRP和BNP水平可以作为预测指标,对高危老年患者进行充分评估、从而减少围手术期心脏不良事件的发生。Objective： To explore influence factors of adverse cardic events in perioperative period of noncardiac surgery in elderly patients. Methods： A research was made on 112 elderly patients receiving noncardiac surgery. We analyzed related factors to adverse cardiac events in perioperative period,evaluated the difference between groups which suffered cardic adverse events and that did not. Results： There were 42 cases of adverse cardiac events in postoperative period（ 37. 5%）. Compared with group without cardic adverse events,in group with cardic adverse events,most with coronary heart disease,valvular heart disease,arrhythymia,preoperative ejection fraction 50%,undergoing percutaneous coronary intervention,coronary artery bypass graft,major surgery,long duration of anesthesia,the level of hs-CRP and BNP was increased（ P〈0. 05）.Conclusion： The risk factors of adverse cardic events in perioperative period of noncardiac surgery in elderly patients were with coronary heart disease,valvular heart disease,arrhythymia,preoperative ejection fraction 50%,undergoing percutaneous coronary intervention,coronary artery bypass graft,major surgery,long duration of anesthesia,the preoperative increased levels of hs-CRP and BNP. Among these,the preoperative levels of hs-CRP and BNP has good predictive effects,for the high risk elderly patients with preoperative detection of levels of hs-CRP and BNP can fully evaluate the condition,to reduce the incidence of adverse cardiac events in perioperative period.

关 键 词：老年患者 非心脏手术 围手术期 心脏不良事件 高敏C反应蛋白 B型利钠肽 

分 类 号：R54[医药卫生—心血管疾病]