平板运动试验在胸外科手术前的评估价值

目的 研究胸外科术前常规进行平板运动试验评估心血管风险的有效性。方法 回顾性入选2016.1~2016.6期间我院273例拟接受胸外科手术的的患者,常规进行运动平板评估,并随访至围手术期结束。结果 273名患者中,231名患者平板运动阴性,35人阳性,7人可疑阳性,阳性及可疑阳性患者均接受冠脉造影检查。其中8人接受预防性PCI手术,1人放弃后续治疗,14人存在冠脉非显著病变,19人完全正常。共有264名患者接受了胸外科手术,围术期心梗1人。平板运动试验的敏感性为95.8%,特异性为92.4%,阳性预测价值54.8%,阴性预测价值99.6%,准确率92.7%。 结论 胸外科手术是一种高危或中高危手术,术前常规平板运动试验敏感性较高,能识别绝大多数潜在心血管风险的患者,而且临床应用简便经济,可以得到进一步推广。

Value Analysis of Treadmill Exercise Test in Department of Thoracic Surgery

Objective: To evaluate the surgical risk in department of thoracic surgery by treadmill exercise tes. Methods: During the 2016.1~2016.6 period, 273 patients who underwent surgery in the department of thoracic surgery were evaluated with routine treadmill exercise and followed up until the end of the perioperative period. Results: 231 patients with negative treadmill exercise test and 42 patients with positive treadmill exercise test. All 42 patients underwent coronary angiography, and 8 received percutaneous coronary intervention (PCI). A total of 264 patients underwent department of thoracic surgery surgery, perioperative myocardial infarction was 1. The sensitivity of treadmill exercise test was 95.8%, specificity was 92.4%, positive predictive value was 54.8%, negative predictive value was 99.6%, accuracy rate was 92.7%. Conclusion: Department of thoracic surgery is a high risk surgery.Preoperative routine treadmill exercise test with higher sensitivity, can identify most of the potential cardiovascular risk patients, but the clinical application is simple and economic, can be further popularized.