CAJ | 학술논문

背景围术期多种因素可能导致心肌缺血和心肌梗死,了解其发生机制,有效预防,可降低围术期心脏事件发生率.目的探讨围术期心肌缺血和心肌梗死的发生机制及有效预防措施.内窖冠状动脉粥样硬化后冠脉内皮对交感神经、副交感神经兴奋的反应性发生改变以及围术期特殊的病理生理状态是围术期心肌缺血和心肌梗死发生的主要机制.对于冠心病患者加强围术期心肌缺血和心肌梗死的监测与诊断,加强围术期药物治疗维持斑块稳定性、维持氧供需平衡,并完善术后镇痛、加强保温、避免血糖过高可减少围术期心肌缺血和心肌梗死的发生.趋向冠心病患者非心脏手术前常规预防性药物的治疗时间与获益的关系以及术前冠脉重建的价值尚需进一步探讨.
배경 위술기다충인소가능도치심기결혈화심기경사,료해기발생궤제,유효예방,가강저위술기심장사건발생솔.목적 탐토위술기심기결혈화심기경사적발생궤제급유효예방조시.내교관상동맥죽양경화후관맥내피대교감신경、부교감신경흥강적반응성발생개변이급위술기특수적병리생리상태시위술기심기결혈화심기경사발생적주요궤제.대우관심병환자가강위술기심기결혈화심기경사적감측여진단,가강위술기약물치료유지반괴은정성、유지양공수평형,병완선술후진통、가강보온、피면혈당과고가감소위술기심기결혈화심기경사적발생.추향 관심병환자비심장수술전상규예방성약물적치료시간여획익적관계이급술전관맥중건적개치상수진일보탐토.
Background Many perioperative factors may result in myocardial ischaemia and myocardial infarction. Better understanding of the mechanism and effective prevention of it are all essential to decrease the incidence of perioperative cardiac event. Purpose To investigate the mechanism of perioperative myocardial ischaemia and myocardial infarction and their effective preventive measures. Content The change of the responsiveness of coronary atherosclerosis endodermis to sympathetic and parasympathetic stimulius along with the special pathophysiologic states may contribute to perioperative myocardial ischaemia and myocardial infarction. For patients with coronary artery disease, enhancing the monitor and diagnose of perioperative myocardial ischaemia and myocardial infarction, maintaining the stabilization of plaque and the banlance of myocardial oxygen supply and demand, improving postoperative analgesia, keeping normothermia and the avoidance of high blood glucose can decrease the incidence of perioperative myocardial infarction. Trend The relationship between the treatment duration of preoperative prophylactic drug therapy and the advantage as well as the value of preoperative coronary artery reconstitution for patients with coronary artery disease undergoing noncardiac operation still need to be researched.