[非心脏手术患者的心血管管理]。

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Herz Pub Date : 2024-10-21 DOI:10.1007/s00059-024-05274-x
Stephan H Schirmer
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引用次数: 0

摘要

在非心脏手术(NCS)前对心血管疾病患者进行风险评估与心脏病学尤为相关,因为非心脏手术(NCS)的频率很高,而且涉及不同的学科。风险由手术本身和疾病或风险状况(包括患者的年龄)决定。因此,如果与手术相关的风险较低,术前专家会诊可能仍然有限。主观症状(运动耐量)以及心脏生物标志物 N-末端前脑钠尿肽(NT-proBNP)和肌钙蛋白的测定对于评估仪器或专科检查的适应症尤为重要。心血管药物治疗应主要在围手术期继续进行,而不是仅仅为了手术才开始。目前已有暂停口服抗凝药的实用指南,不再建议使用普通肝素桥接。
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[Cardiovascular management of patients undergoing noncardiac surgery].

The risk assessment of patients with cardiovascular diseases before noncardiac surgery (NCS) is particularly relevant in cardiology because of the frequency and the involvement of different disciplines. The risk is determined by the operation itself and the disease or risk profile, including the patient's age. Specialist preoperative consultation can therefore remain limited if the surgery-related risk is low. The subjective symptoms (exercise tolerance) and also the determination of the cardiac biomarkers N‑terminal pro-brain natriuretic peptide (NT-proBNP) and troponin are particularly relevant for assessing the indications for an instrumental or specialist examination. Cardiovascular drug treatment should predominantly be continued perioperatively but not initiated just for the operation. There are practical guidelines for pausing oral anticoagulation, whereby a general heparin bridging is no longer recommended.

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来源期刊
Herz
Herz 医学-心血管系统
CiteScore
3.00
自引率
5.90%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.
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