Reeder M K, Muir A D, Foëx P, Goldman M D, Loh L, Smart D
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Headington, Oxford.
Br J Anaesth. 1991 Nov;67(5):626-31. doi: 10.1093/bja/67.5.626.
Three patients presenting for elective aortic surgery were studied before operation and for up to 3 days after operation with ambulatory electrocardiographic monitoring and nocturnal pulse oximetry. Supplementary oxygen was administered for the first 2 days after operation and withdrawn on the 3rd morning after operation. Heart rate remained increased for the first 3 days after operation. Two patients developed episodes of myocardial ischaemia during the first 48 h after operation while their arterial oxygen saturation remained greater than 90%. On the third day, and during the third night after operation, both the severity and duration of myocardial ischaemia increased markedly, associated with arterial hypoxaemia. A temporal relationship between decreases in oxygen saturation and fluctuations in ST segment level were observed in the three patients.
对3例择期行主动脉手术的患者在术前及术后长达3天的时间里进行了动态心电图监测和夜间脉搏血氧饱和度测定。术后头2天给予补充氧气，术后第3天早晨停用。术后头3天心率持续升高。2例患者在术后48小时内出现心肌缺血发作，而此时他们的动脉血氧饱和度仍大于90%。术后第3天及术后第3个夜间，心肌缺血的严重程度和持续时间均显著增加，同时伴有动脉血氧不足。在这3例患者中均观察到血氧饱和度下降与ST段水平波动之间存在时间关系。
