[1]张 凯,魏 昕,丁 盟,等.老年房颤患者非心脏手术围术期心脑血管事件的危险因素分析[J].医学信息,2021,34(06):122-125.[doi:10.3969/j.issn.1006-1959.2021.06.031]
　ZHANG Kai,WEI Xin,DING Meng,et al.Analysis of Risk Factors for Perioperative Cardiovascular and Cerebrovascular Events in Elderly Patients with Atrial Fibrillation[J].Medical Information,2021,34(06):122-125.[doi:10.3969/j.issn.1006-1959.2021.06.031]
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老年房颤患者非心脏手术围术期心脑血管事件的危险因素分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年06期
页码:
122-125
栏目:
临床研究
出版日期:
2021-03-15

文章信息/Info

Title:
Analysis of Risk Factors for Perioperative Cardiovascular and Cerebrovascular Events in Elderly Patients with Atrial Fibrillation
文章编号:
1006-1959（2021）06-0122-04
作者:
张 凯; 魏 昕; 丁 盟; 等
（安徽医科大学附属省立医院麻醉科，安徽 合肥 230001）
Author(s):
ZHANG Kai; WEI Xin; DING Meng; et al.
(Department of Anesthesiology,Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,Anhui,China)
关键词:
房颤; 非心脏手术; 主要不良心脑血管事件; 低血压
Keywords:
Atrial fibrillation; Non-cardiac surgery; Major adverse cardiovascular and cerebrovascular events; Hypotension
分类号:
R541.7+5
DOI:
10.3969/j.issn.1006-1959.2021.06.031
文献标志码:
A
摘要:
目的 分析老年心房颤动患者非心脏手术围术期发生主要心脑血管事件的独立危险因素。方法 选择2017年1月~2020年7月于我院行非心脏手术的年龄≥60岁的房颤患者，根据围术期有无心脑血管事件发生分为A组（无事件患者），B组（发生事件患者），比较两组基本特征、实验室指标、手术指标，并采用多因素Logistic分析围术期主要心脑血管事件的独立危险因素。结果 542例患者中56例患者发生围术期MACCE，其中不稳定心绞痛19例（33.93%）、心肌梗死15例（26.79%）、心力衰竭9例（16.07%）、恶性心律失常（室速）8例（14.29%）、卒中5例（8.93%）。两组年龄、CHADS2评分、Goldman评分、hs-cTnⅠ、BNP、射血分数、低血压、术中输血、手术时间≥150 min、手术类型比较，差异有统计学意义（P＜0.05）；两组性别、BMI、抗凝、桥接、心室率、NYHA分级、ASA分级比较，差异无统计学意义（P＞0.05）。多因素分析显示，射血分数、年龄、高/中危手术、术中低血压是发生围术期主要心脑血管事件的危险因素。结论 老年心房颤动患者择期非心脏手术围术期心脑血管事件发生率较普通人群更高，其中年龄、高危手术、术中低血压和低射血分数均可增加该人群围术期心脑血管事件风险。
Abstract:
Objective To analyze the independent risk factors of major cardiovascular and cerebrovascular events during non-cardiac surgery in elderly patients with atrial fibrillation.Methods Selecting patients with atrial fibrillation ≥60 years old who underwent non-cardiac surgery in our hospital from January 2017 to July 2020.According to the occurrence of cardiovascular and cerebrovascular events during the perioperative period, they were divided into group A (patients without incident) and group B (patients with incident).The basic characteristics, laboratory indicators, and surgical indicators were compared between the two groups, and multivariate Logistic was used to analyze the independent risk factors of major perioperative cardiovascular and cerebrovascular events.Results 56 of the 542 patients had MACCE during the perioperative period, including 19 cases of unstable angina (33.93%), 15 cases of myocardial infarction (26.79%), 9 cases of heart failure (16.07%), and malignant arrhythmia (ventricular tachycardia) 8 cases (14.29%) and 5 strokes (8.93%).There was a statistically significant difference in age, CHADS2 score, Goldman score, hs-cTnⅠ, BNP, ejection fraction, hypotension, intraoperative blood transfusion, operation time ≥150 min, and operation type between the two groups (P<0.05);There was no significant difference in gender, BMI, anticoagulation, bridging, ventricular rate, NYHA classification, and ASA classification between the two groups (P>0.05).Multivariate analysis showed that ejection fraction, age, high/medium risk surgery, and intraoperative hypotension were the risk factors for major perioperative cardiovascular and cerebrovascular events.Conclusion The incidence of perioperative cardiovascular and cerebrovascular events during elective non-cardiac surgery in elderly patients with atrial fibrillation is higher than that of the general population.Among them, age, high-risk surgery, intraoperative hypotension and low ejection fraction can all increase the risk of perioperative cardiovascular and cerebrovascular events in this population.

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更新日期/Last Update: 1900-01-01