CAJ | 학술논문

目的应用推衍12导联心电图ST段连续监测得出骨科术中心肌缺血的发生规律.方法对311例骨科患者术中连续监测推衍12导联心电图ST段. 结果患者术中心肌缺血总的发生率为26.0%(81/311),其中全身麻醉患者比局部麻醉患者心肌缺血发生率高(38.1%比23.0%,P＝0.015).有71.6%(58/81)的患者发生心肌缺血时HR＞90次/min.术中发生的心肌缺血事件,79.7%(141/177)持续时间≤5 min;71.2%(126/177)ST段压低≤0.15 mV.结论推衍12导联心电图可用于骨科术中心肌缺血的监测,全身麻醉患者心肌缺血发生率较高,缺血事件大多数同心率增快有关,术中发生的心肌缺血绝大多数持续时间短、ST段压低程度轻.
목적 응용추연12도련심전도ST단련속감측득출골과술중심기결혈적발생규률.방법 대311례골과환자술중련속감측추연12도련심전도ST단. 결과 환자술중심기결혈총적발생솔위26.0%(81/311),기중전신마취환자비국부마취환자심기결혈발생솔고(38.1%비23.0%,P＝0.015).유71.6%(58/81)적환자발생심기결혈시HR＞90차/min.술중발생적심기결혈사건,79.7%(141/177)지속시간≤5 min;71.2%(126/177)ST단압저≤0.15 mV.결론 추연12도련심전도가용우골과술중심기결혈적감측,전신마취환자심기결혈발생솔교고,결혈사건대다수동심솔증쾌유관,술중발생적심기결혈절대다수지속시간단、ST단압저정도경.
Objecfive To investigate possibihty of monitoring myocardial isehemia by eontinuous EASI 12-lead ST-segment trend analysis during orthopaedic surgery and find its rules.Methods Three hundred and eleven consecutive patients who underwent orthopaedic surgery were monitored bv continuous EASI 12-lead ST-segment analysis during surgery.Results Among 311 patients 81 patients(26.0%) had myocardial ischemic events.The ischemie incidence of general anesthetics WaS signifieantly higher than local anesthetics(the spinal or epidural anesthetics and nerve-block anesthetics)(38.1%vs 23.0%.P＝ 0.01 5).During ischemie events the patients whose heart rate exceeded 90 beat per minute was 71.6% (58/81).Among the 177 isehemie events,the duration ofless than 5 minutes was 79.7%(141/177).ST-seg- ment deviation ofless than 0.15 mV was 71.2%(126/177).Conclusions During orthopaedic surgery EASt 12-lead electrocardiogram is the optimal approach for monitoring myocardial isehemia.The ischemic incidence of general anesthetics is significantly higher than local anesthetics.The myocardial ischemia events correlates with fast heart rate.The intraoperative myocardial ischemia events are more often transient.In most of these ischemic events ST-segment deviation is not very serious.