CAJ | 학술논문

目的：评估拔牙手术对冠状动脉旁路移植(CABG)术后患者心血管系统的影响。方法：174例冠状动脉旁路移植术后患者复方阿替卡因注射液(必兰)局部麻醉，心电监护下拔除患牙，记录静息状态下(T0)、麻药注射过程中(T1)、麻药注射后5min(T2)、拔牙术中(T3)及拔牙术后5min(T4)收缩压、舒张压、心率等血流动力学参数、心电图变化和患者症状体征，计算心率-收缩压乘积(RPP)和平均动脉压心率商(PRQ)。结果：160例患者完成拔牙手术，14例患者因收缩压持续升高、频发室性早搏、心绞痛等原因终止拔牙手术。结论：大多数基础病变控制良好的CABG术后患者可以在心电监护下完成拔牙手术。
목적：평고발아수술대관상동맥방로이식(CABG)술후환자심혈관계통적영향。방법：174례관상동맥방로이식술후환자복방아체잡인주사액(필란)국부마취，심전감호하발제환아，기록정식상태하(T0)、마약주사과정중(T1)、마약주사후5min(T2)、발아술중(T3)급발아술후5min(T4)수축압、서장압、심솔등혈류동역학삼수、심전도변화화환자증상체정，계산심솔-수축압승적(RPP)화평균동맥압심솔상(PRQ)。결과：160례환자완성발아수술，14례환자인수축압지속승고、빈발실성조박、심교통등원인종지발아수술。결론：대다수기출병변공제량호적CABG술후환자가이재심전감호하완성발아수술。
Objective:To evaluate the safety of tooth extraction in patients after coronary artery bypass graft (CABG) operation under local anesthesia with 4% articaine hydrochloride with 1∶100000 epinephrine.Methods:A total of 174 patients requiring tooth extraction under local infiltration anesthesia or nerve block anesthesia with 1-3 capsules of articaine were enrolled in this study. The following hemodynamic parameters were observed during the operation at 5 different moments: systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR), the electrocardiogram changes, rate pressure product(RPP), pressure rate quotient(RPQ) and the symptoms were also involved in estimation.Results:160 patients completed the operation and 14 patients were dropped due to elevated blood pressure, arrhythmia, chest pain, et al. SBP was increased significantly during injection of anesthetic solution (P=0.038) and tooth extraction (P=0.012); RPP was also ascended significantly during tooth extraction(P=0.025). No statistical changes were observed with DBP, HR and RPQ at any different moments.Conclusion:Most patients after CABG could finish tooth extraction under electrocardiographic monitoring; the procedure was safe by means of careful preparation and gentle performance.