非心脏手术患者围术期心肌梗死的特点及危险因素Risk factors of perioperative myocardial infarction in the patients undergoing noncardiac surgery
崔军凯,余阳,周文君,柳梅
摘要(Abstract)：
目的研究非心脏手术患者围术期心肌梗死的高危因素及预后。方法选取562例非心脏手术患者,收集患者的围术期病例资料,统计患者心肌梗死危险因素,围术期心肌梗死的发生率及特点。结果在562例患者中共有19例发生围术期心肌梗死,发生率为3.4%,发生时间为术后(43.5±12.7)h。其中非ST段抬高心肌梗死11例,ST段抬高心肌梗死8例;左冠状动脉梗死14例,右冠状动脉梗死5例。年龄、既往有心肌梗死病史、术前有不稳定型心绞痛、术前心电图ST-T段改变、术前冠状动脉病变、术前糖尿病、术前高血压病、非心脏手术的级别均是围术期心肌梗死的高危因素,且与围术期心肌梗死的发生相关。19例心肌梗死的患者中,有16例行急诊经皮冠状动脉介入治疗,3例行药物保守治疗,处置后2例仍有不稳定型心绞痛,1年内出现心功能下降1级及1级以上的患者有2例,心律失常1例,未再发生心肌梗死病例,无死亡病例。结论多种因素会导致围术期心肌梗死的发生,加强术前评估,对存在高危因素的患者给予预防措施,一旦发生心肌梗死,及时处理,绝大部分患者预后尚可。
关键词(KeyWords)： 非心脏手术;围术期;心肌梗死
基金项目(Foundation):
作者(Author): 崔军凯,余阳,周文君,柳梅
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