高龄食管癌术后心律失常的相关因素及预防

Risk factors and prevention of early postoperative cardiac arrhythmia in elderly patients with esophageal carcinoma

关键词:  食管癌术后  心律失常  相关因素

Key words:  post esophagectomy  cardiac arrhythmia  correlative risk factor

摘要:

目的 探讨高龄食管癌术后心律失常的危险因素及预防措施。方法 对113例术后入住ICU患者进行连续性心电监护,每30min通过心电网络监护总结并记录其心电图。结果 44例发生心律失常,心律失常的发生率38.93%,术后24h内是高峰。FEV1/FVC（≤70%）、术前心肺部合并症（本研究中包括肺性心脏病、高血压性心脏病、冠心病）、手术方式、术前血钾（＜4.0mmol/L）与高龄食管癌术后心律失常发生有显著相关性。结论 对高龄有相关因素的患者,术前针对性积极治疗心肺合并症及适当补钾,改善低肺功能,选择合适的术式均能预防和减少心律失常的发生。

Abstract:

Objective To investigate risk factors and prevention of postoperative cardiac arrhythmia in elderly patients with esophageal carcinoma.Methods One hundred and thirteen elderly patients with esophageal carcinoma undergoing esophagectomy were monitored in intensive care unit.The ECG was recorded and analyzed every 30min by the ECG monitoring system.Results Various types of cardiac arrhythmia occured in 44 cases(38.93%) after operation;and most of them took place within 24 h after operation.Postoperative cardiac arrhythmia was significantly correlated with FEV1/FVC≤70%,cardiopulmonary complications(including pulmonary heart disease,hypertensive heart disease, coronary heart disease),selection of operation modalities,hypokalemia(＜4.0mmol/L) before operation. Conclusion To reduce postoperative cardiac arrhythmia for elderly patients with esophageal carcinoma, it is necessary to manage the cardiopulmonary complications,improve cardiac-pulmonary function,select optimal operation modality and correct hypovolemia before operation.