非心脏手术的心脏病人管理。

Anestezjologia intensywna terapia Pub Date : 2011-04-01
Olav Münter Sellevold, Roar Stenseth
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引用次数: 0

摘要

接受非心脏手术的心脏病患者比其他人经历更多的围手术期问题。预防这些问题包括术前适当的患者评估,术中仔细的管理和术后监测。术前检查,如有必要,包括超声心动图,是至关重要的。术前用药(如-受体阻滞剂、他汀类药物)的需要应仔细考虑。术中管理需要目标导向的血流动力学监测和治疗以及适当的液体输注。在这类患者中,没有数据证实全身麻醉优于区域麻醉。然而,局部阻断后观察到肺部并发症发生率较低,死亡率较低。
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Management of cardiac patients for non-cardiac surgery.

Patients with cardiac diseases undergoing non-cardiac surgery experience more perioperative problems than the others. The prevention of these problems includes proper preoperative evaluation of patients, careful intraoperative management and postoperative surveillance. Preoperative examination of such patients, including echocardiography if necessary, is crucial. The need for preoperative medication (e.g. beta-blockers, statins) ought to be carefully considered. Intraoperative management requires goal-directed haemodynamic monitoring and therapy as well as proper fluid infusion. There are no data confirming the superiority of general over regional anaesthesia in such patients. However, lower incidence of pulmonary complications and lower mortality rates were observed after regional blocks.

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