Crosby L H, Woll K R, Wood K L, Pifalo W B
Cardiopulmonary Rehabilitation Department, Allegheny General Hospital, Pittsburgh, PA 15212.
Heart Lung. 1990 Nov;19(6):666-70.
The purpose of this study was to evaluate patient activities, professional staff activities, backrest position, and diurnal variations as factors that may contribute to the onset of supraventricular tachyarrhythmias (SVT) after coronary artery bypass surgery (CABG). The activities surrounding the recognition of first-onset SVT, as well as preoperative and postoperative data and patient characteristics were examined in 249 patients having CABG. One hundred seventy-three patients qualified for the study; 28% of these patients (n = 49) had SVT. No statistical difference was found between the subjects with SVT and those without SVT when sex, cross-clamp time, creatine kinase peak, hemoglobin and hematocrit levels, and number of bypasses were examined. Patients who had SVT were older than those who did not: 64.8 years for the SVT group versus 60.7 years for the non-SVT group (p less than 0.01). SVT was rare in the first 24 hours after surgery, whereas 60% of the cases occurred during the next 48 hours, without significant diurnal variation: mean time of onset was 11:50 AM. No particular activity of the patient or nurse influenced the onset of SVT during the postoperative period in this group.
本研究的目的是评估患者活动、专业医护人员活动、靠背位置以及昼夜变化等因素，这些因素可能与冠状动脉旁路移植术（CABG）后室上性快速心律失常（SVT）的发作有关。对249例行CABG的患者，研究了首次发作SVT前后的活动情况、术前和术后数据以及患者特征。173例患者符合研究条件；其中28%（n = 49）的患者发生了SVT。在比较发生SVT的患者和未发生SVT的患者时，在性别、交叉钳夹时间、肌酸激酶峰值、血红蛋白和血细胞比容水平以及旁路数量方面未发现统计学差异。发生SVT的患者比未发生SVT的患者年龄更大：SVT组为64.8岁，非SVT组为60.7岁（p < 0.01）。SVT在术后24小时内很少见，而60%的病例发生在接下来的48小时内，且无明显的昼夜变化：平均发作时间为上午11:50。在该组患者术后期间，患者或护士的特定活动并未影响SVT的发作。
