摘要
目的 探讨非心脏手术围手术期心血管并发症的影响因素。方法 将 1988年至 1997年住院的 6 0岁至 99岁大中型非心脏手术患者 16 5 8例分为心血管并发症组和无心血管并发症组 ,对比分析两组年龄、性别、手术类型、内科主要疾病史等对围手术期心血管并发症的影响 ,并探讨其发生的时间分布。结果 2 72例心血管并发症中 80 %以上发生在术中及术后 72h以内。心血管并发症组平均年龄 (6 9± 6 )岁 ,无心血管并发症组 (6 7± 6 )岁(P <0 .0 1)。与无心血管并发症相比 ,心血管并发症组年龄≥ 70岁、男性、急诊手术、肺叶切除术、前列腺摘除术多。心血管并发症组心血管疾病及其他内科疾病史及体征 ,特别是患有两种以上心血管疾病及其他内科疾病者较无心血管并发症组显著增多 (38.6 %比 18.6 %和 5 7.4 %比 32 .0 % ,P <0 .0 0 1)。结论 年龄、性别、手术类型、心血管和其他内科病史及体征 ,尤其是患有两种以上心血管及其他内科病是老年非心脏手术围手术期心血管并发症发生的主要危险因素。术中、术后 72h内是心血管并发症的高发期 ,应严密监测 ,积极防治。
Objective To investigate the risk factors of perioperative cardiovascular complications (PCCs) in elderly patients undergoing noncardiac surgery. Methods Consecutive 1 658 patients aged 60-99 years old underwent major noncardiac procedures during period from January 1988 to December 1997 were divided into two groups according to the patients with or without PCCs. The patients were analyzed for age, sex, type and nature of surgery, clinical history of cardiovascular or internal diseases. The time distribution of occurrence of PCCs was evaluated. Results Among 272 cases with PCCs, more than 80% of cardiovascular complications occurred during or within 72h after operation. The average age of the patients with PCCs was older than the patients without PCCs 〔(69±6) vs( 67±6)years old,P< 0.01 〕. Compared with the group without PCCs the group with PCCs had more men patients aged ≥70 years old with emergency operation, lobotomy of lung, prostatectomy, and clinical history and signs of cardiovascular or other internal disease, especially more than two kinds of cardiovascular or other internal diseases(38.6% vs 18.6% and 57.4% vs 32.0%, P< 0.001 ). Conclusions Age, gender, type and nature of surgery, clinical history of cardiovascular or internal diseases, especially more than two kinds of cardiovascular or internal diseases, are major risk factors of PCCs in the old patients undergoing noncardiac surgery. The PCCs occur more frequently during or within 72h after operation.
出处
《中华老年多器官疾病杂志》
2002年第2期93-96,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
