Gögenur Ismail, Rosenberg-Adamsen Susan, Lie Claus, Rasmussen Verner, Rosenberg Jacob
Department of Surgical Gastroenterology, University of Copenhagen, Hvidovre Hospital, Denmark.
Eur J Surg. 2002;168(4):242-6. doi: 10.1080/11024150260102861.
Most sudden postoperative deaths occur during the night and we conjectured that this was associated with circadian variations in the autonomic nervous tone, reflected in heart rate variability.
Prospective clinical study.
University hospital, Denmark.
44 patients who had had major abdominal operations.
Patients were monitored with 24-hour Holter ECG on the second postoperative day-evening-night. We calculated heart rate variability from the standard deviation of all normal R-R intervals (excluding ectopics-NN intervals) around the mean NN interval for the period of measurement (SDNN), the root mean square of the standard deviation of the differences between NN intervals (RMSSD), the percentage of NN intervals differing by more than 50 msec from adjacent NN intervals (pNN50) and the coefficient of component variance (meanNN/SDNN).
Heart rate and heart rate variability.
Circadian variation calculated from the SDNN (p = 0.43) the pNN50 (p = 0.11), the RMSSD (p = 0.47), and mean NN:SDNN ratio (p = 0.13) was absent postoperatively. Circadian variation in the heart rate was present but was set on a higher level compared with reference values.
After major abdominal operations there was a lack of circadian variation in the autonomic nervous tone.
大多数术后猝死发生在夜间，我们推测这与自主神经张力的昼夜变化有关，心率变异性可反映这种变化。
前瞻性临床研究。
丹麦大学医院。
44例接受腹部大手术的患者。
术后第二天傍晚至夜间对患者进行24小时动态心电图监测。我们根据测量期间平均NN间期周围所有正常R-R间期（不包括异位搏动——NN间期）的标准差（SDNN）、NN间期差值标准差的均方根（RMSSD）、与相邻NN间期相差超过50毫秒的NN间期百分比（pNN50）以及成分方差系数（meanNN/SDNN）计算心率变异性。
心率和心率变异性。
术后，根据SDNN（p = 0.43）、pNN50（p = 0.11）、RMSSD（p = 0.47）和平均NN:SDNN比值（p = 0.13）计算得出的昼夜变化不存在。心率存在昼夜变化，但与参考值相比处于较高水平。
腹部大手术后自主神经张力缺乏昼夜变化。
