Toro Ibáñez D, Casielles García J L, de las Mulas Béjar M
Departamento de Anestesiología y Reanimación, Hospital Universitario Virgen Macarena, Sevilla.
Rev Esp Anestesiol Reanim. 1999 Jan;46(1):9-13.
To determine the frequency of episodes of cardiac arrhythmia during the period following elective exeresis of the pulmonary parenchyma (pneumonectomies, double and single lobectomies), and to study the temporal patterns of occurrence and the association of arrhythmia and certain risk factors.
Retrospective analysis of data recorded in the case histories of 100 patients admitted to the postoperative intensive care unit (PICU) between November 1991 and March 1995.
We monitored changes in heart rate after surgery by continuous electrocardiography in 38 of the 100 patients (38%). Changes were more common in certain subgroups: older patients, those with preoperative cardiovascular and electrocardiographic abnormalities, and those who needed prolonged postoperative mechanical ventilation. Most arrhythmias were supraventricular (97.3%), the most common being atrial fibrillation (55.3%). Most diagnoses of arrhythmia (87%) were made within the first three days after surgery. Several drugs were used for treatment, based on the diagnosing anesthesiologist's criteria. Digitalis was the drug most often prescribed. Seven patients (7%) died in the PICU. Three were discharged with atrial fibrillation with ventricular response of less than 100 beats per minute. Postoperative cardiac arrhythmia was a direct cause of death of only one patient, who had ventricular fibrillation upon admission to the PICU.
确定在择期肺实质切除术后（全肺切除术、双叶和单叶肺叶切除术）期间心律失常发作的频率，并研究其发生的时间模式以及心律失常与某些危险因素之间的关联。
对1991年11月至1995年3月期间入住术后重症监护病房（PICU）的100例患者病历记录的数据进行回顾性分析。
我们对100例患者中的38例（38%）通过连续心电图监测术后心率变化。在某些亚组中变化更为常见：老年患者、术前有心血管和心电图异常的患者以及术后需要长时间机械通气的患者。大多数心律失常为室上性（97.3%），最常见的是心房颤动（55.3%）。大多数心律失常诊断（87%）在术后头三天内做出。根据诊断麻醉医生的标准使用了几种药物进行治疗。洋地黄是最常开具的药物。7例患者（7%）在PICU死亡。3例患者出院时伴有心室率低于每分钟100次的心房颤动。术后心律失常仅为1例患者的直接死因，该患者入住PICU时发生心室颤动。
