Klinik für Allgemein-, Visceral-, Gefäss- und Thoraxchirurgie, Charite Campus Mitte, Universitätsmedizin Berlin, Chariteplatz 1, 10117 Berlin, Germany.
Langenbecks Arch Surg. 2012 Jun;397(5):793-9. doi: 10.1007/s00423-012-0903-2. Epub 2012 Jan 17.
Heart rate variability (HRV) is a sensitive marker of altered sympathetic-parasympathetic function and is reduced in inflammation, illness, and trauma. The effect of major abdominal surgery on the course of HRV parameters is still an issue requiring further investigation.
A prospective, observational study including 40 consecutive patients undergoing elective colorectal surgery under "fast-track" perioperative management. Time and frequency domain parameters of HRV were measured 1 day prior to operation and on days 1-5 postoperatively. General and surgical complications as well as the course of leucocytes and C-reactive protein (CRP) were documented and correlated to the HRV measurements.
Time domain parameters of HRV showed a significant decrease compared to the preoperative values on postoperative day 1 and returned to baseline on day 2, demonstrating impaired autonomic regulation in the early postoperative period. No correlation to complications or course of leukocytes or CRP was significant in our study.
Colorectal resections significantly influence the HRV course. The autonomic regulation is reduced in the early postoperative time and all parameters return to baseline until the third day.
心率变异性（HRV）是交感神经-副交感神经功能改变的敏感标志物，在炎症、疾病和创伤中减少。腹部大手术对 HRV 参数变化的影响仍然是一个需要进一步研究的问题。
一项前瞻性、观察性研究，纳入 40 例在“快速通道”围手术期管理下接受择期结直肠手术的连续患者。在手术前 1 天和术后第 1-5 天测量 HRV 的时域和频域参数。记录一般和手术并发症以及白细胞和 C 反应蛋白（CRP）的病程，并与 HRV 测量相关联。
与术前值相比，术后第 1 天的 HRV 时域参数显著降低，第 2 天恢复到基线，表明术后早期自主调节受损。在我们的研究中，与并发症或白细胞或 CRP 的病程无显著相关性。
结直肠切除术显著影响 HRV 进程。自主调节在术后早期时间减少，所有参数在第三天恢复到基线。
