圍手術(shù)期間急性心肌缺血及急性心肌梗死-展示頁
2025-01-11 10:31本頁面
【正文】 需超過氧供時，供需之間失去平衡，即可發(fā)生心肌缺血，甚至心肌 梗死。因此，及時、有效地診斷和處理圍手術(shù)期急性心肌缺血可明顯改善患者的預(yù)后。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 (MONTHS) TARHAN, ET AL RAO, ET AL SHAH, ET AL 1972 BEFORE 1977 1977 AND AFTER 1990 0–3 37 36 4–6 16 26 0 6 5 Time unknown — — — 圍手術(shù)期急性心肌缺血與急性心肌梗死 冠心病在我國的發(fā)病率有增加的趨勢，手術(shù)病人中冠心病病人也相應(yīng)增多。由于麻醉、手術(shù)創(chuàng)傷和其他因素影響，冠心病病人在圍手術(shù)期可發(fā)生急性心肌缺血、甚至急性心肌梗死（ AMI），手術(shù)危險性大于一般病人。 病因和發(fā)病機制 病理生理 監(jiān)測與診斷標(biāo)準(zhǔn) 防治 預(yù)后 圍手術(shù)期急性心肌缺血與急性心肌梗死 病因與發(fā)病機制 心肌氧供下降 –冠狀
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