摘要
本文总结、分析了３８例冠心病外科手术的麻醉处理。提出：①欲不增加心肌的工作负荷、维持其氧的供需平衡，应使心率保持在（或微慢于）术前安定状态下的水平。②为避免加重心肌缺血，必须维持良好的组织灌注，使ＭＡＰ（平均动脉压）－ＰＣＷＰ（肺毛细血管楔压）＞６．６７ｋｐａ（５０ｍｍＨｇ）及ＭＡＰ与心率的比值＞１（ＭＡＰ以ｍｍＨｇ）计。③硝酸甘油的应用在围术期占重要位置。不宜常规或＂预防性＂地使用正性肌力药。④室性心律失常是导致患者围术期猝死的一个重要原因，须注意预防和处理。
Essentials on anesthesia management of 38 patients with coronary artery disease undergoing cardiac surgery were analyzed. It revealed that: (1) For the maintenance of myocardial oxygen balance without contractility overload, stable heart rate should be kept on the resting preoperative-level or even lower throughout. (2) To avoid episodes of additional myocardial ischemia, perfusion is necessary to let the difference between MAP and PCWP more than 6. 67 kPa; in association with the ratio of MAP/HR great than l as suggested (MAP in mmHg).(3) Perioperative appropriate nitroglycerin therapy is important. On the contrary, no need for routine or preventive use of positive inotropics. (4)ventricular dysrrhythmias , often predispose to sudden death. must be prevented if possible, and treated effectively the sooner the better.
出处
《中国循环杂志》
CSCD
1995年第7期424-426,共3页
Chinese Circulation Journal
关键词
冠心病
外科手术
麻醉
Coronary heart disease
Anesthesia
