围术期心肌缺血和心肌梗死研究进展

背景 围术期多种因素可能导致心肌缺血和心肌梗死,了解其发生机制,有效预防,可降低围术期心脏事件发生率.目的 探讨围术期心肌缺血和心肌梗死的发生机制及有效预防措施.内窖冠状动脉粥样硬化后冠脉内皮对交感神经、副交感神经兴奋的反应性发生改变以及围术期特殊的病理生理状态是围术期心肌缺血和心肌梗死发生的主要机制.对于冠心病患者加...

Progress in perioperative myocardial ischaemia and myocardial infarction

Background Many perioperative factors may result in myocardial ischaemia and myocardial infarction. Better understanding of the mechanism and effective prevention of it are all essential to decrease the incidence of perioperative cardiac event. Purpose To investigate the mechanism of perioperative myocardial ischaemia and myocardial infarction and their effective preventive measures. Content The change of the responsiveness of coronary atherosclerosis endodermis to sympathetic and parasympathetic stimulius along with the special pathophysiologic states may contribute to perioperative myocardial ischaemia and myocardial infarction. For patients with coronary artery disease, enhancing the monitor and diagnose of perioperative myocardial ischaemia and myocardial infarction, maintaining the stabilization of plaque and the banlance of myocardial oxygen supply and demand, improving postoperative analgesia, keeping normothermia and the avoidance of high blood glucose can decrease the incidence of perioperative myocardial infarction. Trend The relationship between the treatment duration of preoperative prophylactic drug therapy and the advantage as well as the value of preoperative coronary artery reconstitution for patients with coronary artery disease undergoing noncardiac operation still need to be researched.