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扩张型心肌病患者非心脏手术的麻醉管理。

Anesthetic Management of Patients with Dilated Cardiomyopathy Undergoing Noncardiac Surgery.

机构信息

Department of Anesthesiology and Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Medicina (Kaunas). 2023 Aug 29;59(9):1567. doi: 10.3390/medicina59091567.

Abstract

Dilated cardiomyopathy (DCM), a primary myocardial disease, is characterized by dilation of the left or both ventricles and systolic dysfunction with or without congestive heart failure. DCM per se is a well-recognized risk factor for sudden cardiac death and poor surgical outcomes following noncardiac surgery. Surgical trauma/stress represents unique challenges for DCM patient management. Unfortunately, there is a big knowledge gap in managing DCM patients undergoing non-cardiac surgery. Therefore, the aim of our review is to provide basic facts and current advances in DCM, as well as a practical guideline to perioperative care providers, for the management of surgical patients with DCM, who are quite rare compared with the general surgical population. This review summarizes recent advances in the medical management of DCM as well as perioperative assessment and management strategies for DCM patients undergoing noncardiac surgery. Optimal surgical outcomes depend on multiple-disciplinary care to minimize perioperative cardiovascular disturbances.

摘要

扩张型心肌病(DCM)是一种原发性心肌疾病,其特征为左心室或双心室扩张和收缩功能障碍,伴或不伴有充血性心力衰竭。DCM 本身是心脏性猝死和非心脏手术后手术结局不良的一个公认危险因素。手术创伤/应激对 DCM 患者的管理构成了独特的挑战。不幸的是,在管理接受非心脏手术的 DCM 患者方面存在很大的知识差距。因此,我们的综述旨在为围手术期护理人员提供 DCM 的基本事实和最新进展,以及 DCM 患者的围手术期护理指南,因为与一般手术人群相比,DCM 手术患者相当罕见。本综述总结了 DCM 的药物治疗以及非心脏手术 DCM 患者的围手术期评估和管理策略的最新进展。最佳手术结果取决于多学科护理,以最大限度地减少围手术期心血管紊乱。

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