Supraventricular tachyarrhythmia as early indicator of a complicated course after esophagectomy
Supraventricular tachyarrhythmia as early indicator of a complicated course after esophagectomy
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DOI：
10.1111/j.1442-2050.2005.00487.x
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发表时间：
2005-01-01
影响因子：
2.6
通讯作者：
Hölscher, AH
中科院分区：
文献类型：
--
作者：
Stippel, DL;Taylan, C;Hölscher, AH
对89例连续行标准化手术的患者进行了室上性快速性心律失常(SVT)的发生率、易患危险因素(术前、术中因素和重症监护策略参数)和治疗策略的评估。手术治疗包括经胸食道切除、胃间置及胸腔内吻合术。住院总死亡率为6.7%。32例(37%)患者出现新的室上性心动过速。在多变量分析中，年龄和体温升高是SVT的唯一显著危险因素，其优势比分别为每年高于58摄氏度的1.3和高于摄氏37.8摄氏度的5.6。次要危险因素是高血压病史和肾上腺素的使用，相应的优势比分别为6.6和10.2。洋地黄(2/32)和钙拮抗剂(2/9)效果不佳，而β-受体阻滞剂(13/20)和胺碘酮(12/12)是有效的治疗药物。室上性心动过速的发生与术后脓毒症并发症的发生密切相关。
In a group of 89 consecutive patients with a standardized operative procedure, the incidence of supraventricular tachyarrhythmia (SVT), predisposing risk factors (preoperative and intraoperative factors and parameters of intensive care strategy) and therapeutic strategies were evaluated. Operative treatment consisted of transthoracic esophagectomy, gastric interposition and intrathoracic anastomosis. Overall hospital mortality was 6.7%. In 32 (37%) patients a new onset SVT occurred. Age and elevated body temperature were the only significant risk factor for SVT in the multivariate analysis, their odds ratios being 1.3 for each year above 58 and 5.6 for each degree above 37.8 degrees C, respectively. Secondary risk factors were history of hypertension and use of epinephrine, the corresponding odds ratios being 6.6 and 10.2. Digitalis (2/32) and calcium-antagonists (2/9) were unsatisfactory, while beta-blockers (13/20) and amiodarone (12/12) were efficient therapeutic agents. Incidence of SVT was significantly correlated with the development of postoperative septic complications.