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非心脏手术患者的心脏管理。

Management of cardiac patients for non-cardiac surgery.

作者信息

Münter Sellevold Olav, Stenseth Roar

机构信息

The Norwegian University of Technology and Science, Department of Thoracic Anaesthesia and Intensive Care, Trondheim, Norway.

出版信息

Anestezjol Intens Ter. 2011 Apr-Jun;43(2):104-12.

Abstract

Patients with cardiac diseases undergoing non-cardiac surgery experience more perioperative problems than the others. The prevention of these problems includes proper preoperative evaluation of patients, careful intraoperative management and postoperative surveillance. Preoperative examination of such patients, including echocardiography if necessary, is crucial. The need for preoperative medication (e.g. beta-blockers, statins) ought to be carefully considered. Intraoperative management requires goal-directed haemodynamic monitoring and therapy as well as proper fluid infusion. There are no data confirming the superiority of general over regional anaesthesia in such patients. However, lower incidence of pulmonary complications and lower mortality rates were observed after regional blocks.

摘要

患有心脏病且接受非心脏手术的患者比其他患者经历更多围手术期问题。预防这些问题包括对患者进行适当的术前评估、仔细的术中管理和术后监测。对此类患者进行术前检查至关重要,必要时包括超声心动图检查。应仔细考虑术前用药(如β受体阻滞剂、他汀类药物)的必要性。术中管理需要目标导向的血流动力学监测和治疗以及适当的液体输注。没有数据证实全身麻醉优于此类患者的区域麻醉。然而,区域阻滞术后观察到肺部并发症发生率较低和死亡率较低。

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