Konno O, Tezuka T, Muto A, Hoshino Y, Kogure M, Koyama S, Suzuki H, Inoue H, Motoki R
First Department of Surgery, Fukushima Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Jan;41(1):45-51.
The postoperative arrhythmias (exclusive of sinus tachycardia) was reviewed in 77 patients (male: 69, female: 8, mean age: 63.9 years) who underwent esophagectomy for esophageal carcinoma. The results were as follows: 1. The incidence of postoperative arrhythmias in all patients but seven who had preoperative chronic atrial fibrillation (af) or pacemaker rhythm was 47.1%, and af was observed most frequently (45.5%). Postoperative arrhythmias occurred in patients with abnormal preoperative electrocardiographic findings more often than in those with normal preoperative electrocardiographic findings (53% vs 41%). The incidence of postoperative arrhythmias in aged patients (> or = 66 years old) was significantly higher than that in younger patients (< or = 65 years old) (64% vs 35%, p < 0.05). Other risk factors for postoperative arrhythmias were sex and history of hypertension. 2. Postoperative arrhythmias occurred more often in patients who underwent blunt dissection of the thoracic esophagus and reconstruction using the whole stomach via the posterior mediastinal route than in those who underwent esophagectomy with right thoracotomy and reconstruction using the gastric tube via the poststernal route (60.0% vs 45.0%). 3. Most supraventricular premature contractions and ventricular premature contractions occurred immediately after surgery or on the first postoperative day, and af often occurred during the first postoperative night or the second postoperative day. 4. For treatment, various antiarrhythmic agents were administered according to the patient's condition. Glucose-insulin-kalium therapy was especially effective (63%). None of the arrhythmias was fatal.
对77例因食管癌接受食管切除术的患者（男性69例，女性8例，平均年龄63.9岁）术后心律失常（不包括窦性心动过速）进行了回顾性研究。结果如下：1. 除7例术前有慢性心房颤动（af）或起搏器心律的患者外，所有患者术后心律失常的发生率为47.1%，其中af最为常见（45.5%）。术前心电图异常的患者术后心律失常的发生率高于术前心电图正常的患者（53%对41%）。老年患者（≥66岁）术后心律失常的发生率显著高于年轻患者（≤65岁）（64%对35%，p<0.05）。术后心律失常的其他危险因素为性别和高血压病史。2. 与经右胸切口食管切除术并经胸骨后途径用胃管重建的患者相比，经胸段食管钝性分离并经后纵隔途径用全胃重建的患者术后心律失常的发生率更高（60.0%对45.0%）。3. 大多数室上性早搏和室性早搏发生在术后即刻或术后第1天，af常发生在术后第1个晚上或术后第2天。4. 在治疗方面，根据患者情况给予了各种抗心律失常药物。葡萄糖-胰岛素-钾疗法特别有效（63%）。所有心律失常均非致命性。
