合并急性心肌梗死老年患者股骨头置换术的麻醉与围术期管理  

Anesthesia and perioperative management of a super-elderly patient with acute myocardial infarction undergoing femoral head replacement

作　　者：郭永梅 张玮玮[1] 刁玉刚 李民[3] 梅伟[4] 苏力[5] 尹春琳[6] 郭连瑞[7] 冯明利[8] 薛张纲 王锷[10] 王天龙[11] Guo Yongmei;Zhang Weiwei;Diao Yugang;Li Min;Mei Wei;Su Li;Yin Chunlin;Guo Lianrui;Feng Mingli;Xue Zhanggang;Wang E;Wang Tiaolong(Department of Anesthesia Surgery,Shanxi Provincial People′s Hospital,Taiyuan 030012,China;Department of Anesthesiology,Northern Theater Command General Hospital,Shenyang 110611,China;Department of Anesthesiology,Peking University Third Hospital,Beijing 100191,China;Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Hematology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Cardiology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Vascular Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Orthopedics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Anesthesiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Anesthesia Surgery,Xiangya Hospital,Central South University,Changsha 410012,China;Department of Anesthesiology and Operating Theater,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]山西省人民医院麻醉手术科,太原030012 [2]北部战区总医院麻醉科,沈阳110611 [3]北京大学第三医院麻醉科,北京100191 [4]华中科技大学同济医学院附属同济医院麻醉科,武汉430030 [5]首都医科大学宣武医院血液科,北京100053 [6]首都医科大学宣武医院心内科,北京100053 [7]首都医科大学宣武医院血管外科,北京100053 [8]首都医科大学宣武医院骨科,北京100053 [9]复旦大学附属中山医院麻醉科,上海200032 [10]中南大学湘雅医院麻醉手术部,长沙410012 [11]首都医科大学宣武医院麻醉手术科,北京100053

出　　处：《中华麻醉学杂志》2023年第12期1523-1527,共5页Chinese Journal of Anesthesiology

基　　金：山西省医师协会医师临床研究科研项(YSXH-RF2022MZ001)。

摘　　要：(1)一般情况:患者女性,年龄87岁,身高157 cm,体质量50 kg。因"左髋部疼痛、活动受限6 h"入院。患者6 h前在家中上卫生间时不慎跌倒,致左髋部疼痛、活动受限,无意识丧失,就诊于我院急诊。行X线检查后诊断为左股骨颈骨折,转入骨科拟行手术治疗。完善术前检查,心肌酶:hsTnI 305.2 pg/ml,BNP 454 pg/ml;心电图:窦性心动过速,心率104次/min,ST-T改变;心脏超声:节段性室壁运动异常、左心功能(收缩及舒张)减低,EF 46%、FS 23%、SV 45 ml。

关 键 词：窦性心动过速 股骨头置换术 节段性室壁运动异常 髋部疼痛 左心功能 心脏超声 围术期管理 老年患者 

分 类 号：R614[医药卫生—麻醉学]