摘要
目的探讨冠状动脉旁路移植术(CABG)后早期心律失常的发生及危险因素,以期降低术后心律失常的发生率。方法对2000年10月至2007年12月256例CABG病人术后心律失常发生类型及发生因素进行分析。结果术后早期发生各种心律失常113人次,其中房颤67例,室性早搏51例,室上性心动过速15例,房性早搏5例,室性心动过速2例,有27例发生多种心律失常;年龄≥70岁、心胸比例(C/T)≥0.55、体外循环(CPB)、心肌梗死、射血分数(EF)≤30%及术后低血钾与术后心律失常有密切关系。结论房颤是CABG后最常见的心律失常;为降低CABG后心律失常的发生,术前应改善心功能,提高射血分数并纠正电解质失衡;术中尽量采用非体外循环(off-pump);对高龄、心脏扩大、EF≤30%、术中应用CPB及有心肌梗死病史的病人应想到CABG后有发生心律失常的可能。
Objective To study the incidence of arrhythmia and the risk factors resulting in it after coronary artery bypass grafting （CABG） in order to decrease the incidence of arrhythmia after the operation. Methods The types and risk factors of arrhythmias were analyzed in 256 cases who underwent CABG from Oct. 2000 to Dec. 2007. Results There were 113 cases with arrhythmias after CABG, including 67 cases with atrial fibrillation, 51 cases with ventricular premature beats, 15 cases with supraventricular tachycardia, five cases with atrial premature beats and two cases with ventricular tachyeardia. Among them 27 cases were with more than one type of arrhythmias. Age≥70, C/T≥0.55, cardiopulmonary bypass （CPB）, myocardial infarction （MI）, ejection fraction （EF） ≤30% and postoperative hypokalemia had closely relationship with postoperative arrhythmias. Conclusion Atrial fibrillation is the most common arrhythmia after CABG. Improving cardiac function, increasing EF and correcting electrolytic disorders are necessary to decrease the incidence of arrhythmias after CABG. If possible, CPB should be used in CABG. It＇s very possible that arrhythmias occur in patients with age≥70, cardiac hypertrophy, EF≤30%, CPB in operation and MI.
出处
《福建医药杂志》
CAS
2009年第4期1-3,共3页
Fujian Medical Journal
