老年胆道手术围手术期心功能不全的治疗体会(1)
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[摘要] 目的 探讨心功能不全的老年人行胆道手术的安全性及围手术期处理方法。方法 回顾性分析年龄在65岁以上并接受了胆道手术的住院患者，共119例患者被纳入分析。患者按入院时心功能状态分为观察组及对照组，两组根据患者病情分别进行了干预，如利尿剂、洋地黄、血管紧张素转换酶抑制剂、β受体阻断剂、硝酸酯等药物，以改善心功能、控制高血压、稳定血糖、控制肺部感染、改善心肌缺血、治疗严重心律失常等。经过相应处理后观察两组患者重要心血管事件如死亡、急性心力衰竭、急性心肌梗死等发生率是否不同。结果 两组患者术中、术后重要心血管事件发生率未发现明显不同。结论 老年心功能不全患者经过良好的围手术期处理，进行胆道手术是相对安全可行的。
[关键词] 胆道手术；围手术期；心功能不全；老年
[中图分类号] R657.4 [文献标识码] B [文章编号] 1673-9701(2011)33-30-03
Perioperative Treatment of Cardiac Dysfunction During Biliary Tract Surgery in the Elderly
WANG Qunli1 SUN Jianhui1 ZHU Feng2 DUAN Yunfei2
1.Department of Cardiology, the First People's Hospital of Changzhou City in Jiangsu Province, Changzhou 213003, China; 2.Department of Hepatobiliary Surgery, the First People's Hospital of Changzhou City in Jiangsu Province, Changzhou 213003, China
[Abstract] Objective To investigate the safety of biliary tract surgery and perioperative treatment in the elderly with cardiac dysfunction. Methods One hundred and ninteen cases of patients over 65 years of age and received biliary tract surgery were retrospectively analyzed, and divided into the control group and observation group according to cardiac function by the time of admission. Two groups were carried out intervention according to the patient's condition, such as diuretics, digitalis, angiotensin-converting enzyme inhibitors, β-blockers, nitrates and other drugs to improve heart function, control blood pressure, stabilize blood sugar, control lung infections, improve myocardial ischemia and treat severe arrhythmia. After the appropriate treatment, the incidences of major cardiovascular events, such as death, acute heart failure and acute myocardial infarction in the two groups were observed. Results The intraoperative and postoperative incidences of major cardiovascular events in the two groups had no significant difference. Conclusion After a good perioperative management, the biliary tract surgery in the elderly with cardiac dysfunction is relatively safe and feasible.
[Key words] Biliary tract surgery; Perioperative; Cardiac dysfunction; The elderly
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