圍手術(shù)期間急性心肌缺血及急性心肌梗死-wenkub
2023-01-24 10:31:44 本頁面
【正文】 – 室壁張力 病因與發(fā)病機制 心肌氧供下降 –冠狀動脈灌流量下降 –冠狀動脈血氧含量下降 心肌氧需增加 – 心率 – 心肌收縮力 – 室壁張力 冠狀動脈狹窄 主動脈舒張壓降低 心率增快 病因與發(fā)病機制 心肌氧供下降 –冠狀動脈灌流量下降 –冠狀動脈血氧含量下降 心肌氧需增加 – 心率 – 心肌收縮力 – 室壁張力 冠狀動脈狹窄 主動脈舒張壓降低 心率增快 冠狀動脈粥樣硬化 冠狀動脈痙攣 病因與發(fā)病機制 心肌氧供下降 –冠狀動脈灌流量下降 –冠狀動脈血氧含量下降 心肌氧需增加 – 心率 – 心肌收縮力 – 室壁張力 前負荷 后負荷 在靜息狀態(tài)時，心肌攝氧量已達最大，所以在圍手術(shù)期血流動力學(xué)應(yīng)激狀態(tài)時，必須增加氧供以滿足需要。圍手術(shù)期 急性 心肌缺血與 急性心肌梗死 Incidence of Myocardial Ischemia During the Preoperative, Intraoperative, and Postoperative Periods in Vascular Surgery Patients AUTHORS PREOPERATIVE INTRAOPERATIVE POSTOPERATIVE Pasternack et al Aortic/lower extremity 40 38 48 Carotid 38 41 54 Ouyang et al 12 21 63 McCann and Clements 14 — — Christopherson et al 20 10 40 Mangano et al 20 25 41 Average 24 27 49 Rates of Myocardial Infarction and Death for Patients Undergoing Vascular Surgery AUTHOR (REFERENCE) MI (%) DEATH (%) COMMENTS SHORTTERM FOLLOWUP (IN HOSPITAL) Ouyang et al 8 0 Small study Raby et al Aortic, lower extremity, carotid Mangano et al Vascular patients only reported Bode et al All lower extremity vascular Christopherson et al All lower extremity vascular Mangano et al 0 Vascular patients only reported Fleisher et al Vascular patients only reported Hertzer Older study (1982) Pasternack et al Aortic, lower extremity, carotid Krupski et al Aortic, lower extremity Average LONGTERM FOLLOWUP (IN HOSPITAL + AFTER DISCHARGE) Raby et al 20month followup Mangano et al 15month followup Mangano et al 24month followup Hertzer et al 12 5year followup Krupski et al 24month followup Average 34 year average followup Reinfarction Rates in Patients With Previous Myocardial Infarction TIME ELAPSED BETWEEN PRIOR MYOCARDIAL INFARCTION AND OPERATION (
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