Myocardial Reinfarction After Anesthesia and Surgery
Myocardial Reinfarction After Anesthesia and Surgery
复制标题
麻醉和手术后心肌再梗死
DOI：
10.1001/jama.1978.03280510050018
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发表时间：
1978
期刊：
影响因子：
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通讯作者：
S. Tarhan
中科院分区：
文献类型：
--
作者：
P. Steen;J. Tinker;S. Tarhan
在1974年和1975年期间，在我们的机构，587例曾遭受心肌梗塞的病人接受了麻醉和手术。36例（6.1%）发生再梗死，25例（69%）死亡。在前一次梗死后三个月内手术的患者有27%的再梗死率。如果梗死发生在3 - 6个月之前，则下降至11%，如果间隔超过6个月，则稳定在4%-5%。与再梗死发生率显著增加相关的危险因素包括术前高血压、术中惊厥发作和持续时间超过3小时的非心脏胸部或上腹部手术。麻醉时间与整个组的再梗死率显著相关。术后入住重症监护室对再梗死率无显著影响，糖尿病、心绞痛、患者年龄或性别、既往心肌梗死部位也无显著影响。（JAMA 239：2566-2570，1978）
During the years 1974 and 1975 at our institution, 587 patients who had suffered previous myocardial infarctions underwent anesthesia and surgery. Thirty-six (6.1%) had a reinfarction and 25 (69%) died. Patients operated on within three months of the previous infarction had a 27% reinfarction rate. This decreased to 11% if the infarct had occurred three to six months previously and stabilized at 4% to 5% if the interval was more than six months. Risk factors associated with significantly increased reinfarction rates included preoperative hypertension, intraoperative hypotensive episodes, and noncardiac thoracic or upper abdominal operations of more than three hours' duration. Time under anesthesia was strikingly correlated with reinfarction rates in the entire group. Postoperative intensive care unit admission did not significantly affect the reinfarction rate, nor did diabetes, angina, patient age or sex, or site of the previous myocardial infarction. ( JAMA 239:2566-2570, 1978)