协助高血压患者外科手术466例临床分析

目的探讨心内科协助处理高血压患者外科手术前有否控制血压的必要性。方法回顾本科协助处理的466例行外科手术的高血压病患者围手术期病情变化情况。结果Ⅰ、Ⅱ级高血压患者术前控制血压与否对围手术期病情无显著影响(P>0.05);Ⅲ级及收缩期高血压术前未控制组围手术期并发症明显高于术前控制组,差异有统计学意义(P<0.05);大手术较之中、小手术的围手术期并发症明显,差异有统计学意义(P<0.05);择期手术及急诊手术血压对围手术期的影响明显,差异有统计学意义(P<0.05)。结论Ⅲ级及收缩期高血压术前应尽可能控制血压于正常范围,并尽可能施行择期手术,对未很好控制血压的患者术前尽可能采用快速平稳的药物控制血压。

Clinical analysis of 466 co-treated cases of surgery with hypertension

Objective To evaluate the necessity of control hypertension in surgery patients.Methods From June 2002 to Feb.2003,the perioperative clinical data of 466 patients with hypertention and undergoing surgery in our hospital were retrospectively analyzed.Results The incidences of periopertive hypertensive events were not significantly different between treated and untreated patients with grade one and grade two(P>0.05).In grade three and systolic hypertension,certain perioperative complications in the patients with poorly treated hypertension were heigher than in those with well-treated hypertension(P<0.05);certain perioperative complications also happened in those with big surgery than with small or middle surgery(P<0.05).Complications in cases with elective surgery or emergency surgery with poorly treated hypertension were heigher than in those with well-treated hypertension(P<0.05).Conclusion In the patients with grade three and sysotolic hypertension,perioperative complications are increased and elective surgery should be postponed until their blood pressure is brought to stablity.To poorly treated hypertension,it is necessary to bring down blood pressure with quickly stable drugs before surgery.