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肥厚型心肌病患者围手术期心血管并发症

[Perioperative cardiovascular complications in patients with hypertrophic cardiomyopathy].

作者信息

Kuroiwa Masayuki, Arai Masayasu, Ueno Tetsuo, Takenaka Tomoaki, Okamoto Hirotsugu, Hoka Sumio

机构信息

Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara 228-8520.

出版信息

Masui. 2003 Jul;52(7):733-9.

Abstract

BACKGROUND

The aim of this study was to examine the incidence of cardiac complications in patients with hypertrophic cardiomyopathy (HCM) during noncardiac surgery.

METHODS

A retrospective study was made for surgical patients in the period of 1989-2000 at Kitasato University Hospital.

RESULTS

Thirty out of 66000 patients were preoperatively diagnosed as HCM. Sixty percent of the HCM patients had one or more perioperative cardiovascular complications. There were perioperative congestive heart failure in 3 patients (10%), and myocardial ischemia in 4 patients (13%). However, there were no myocardial infarction, no life-threatening dysarrthythmia and no cardiac death. Factors which appeared to be associated with the perioperative cardiovascular complications were the type of HCM (HOCM), major surgery, general anesthesia and preoperative medication with a beta-blocker or a calcium channel blocker.

CONCLUSIONS

It is suggested that patients with HCM undergoing noncardiac surgery have a high incidence of cardiac complications such as congestive heart failure and myocardial ischemia.

摘要

背景

本研究旨在调查肥厚型心肌病(HCM)患者在非心脏手术期间心脏并发症的发生率。

方法

对1989年至2000年期间在北里大学医院接受手术的患者进行回顾性研究。

结果

66000例患者中有30例术前被诊断为HCM。60%的HCM患者有1种或多种围手术期心血管并发症。3例患者(10%)出现围手术期充血性心力衰竭,4例患者(13%)出现心肌缺血。然而,没有心肌梗死、没有危及生命的心律失常,也没有心脏死亡。似乎与围手术期心血管并发症相关的因素包括HCM的类型(HOCM)、大手术、全身麻醉以及术前使用β受体阻滞剂或钙通道阻滞剂。

结论

提示接受非心脏手术的HCM患者发生充血性心力衰竭和心肌缺血等心脏并发症的发生率较高。

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