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目的:探讨胸部肿瘤切除术后并发心房纤颤的发病机制和防治措施。方法:选用行胸部肿瘤切除术患者486例,术后并发心房纤颤者42例(占8.6 %)。术前心脏功能欠佳、术后心率较快、年老体弱的患者,给予西地兰0.4 mg~0.6 mg,缓慢静脉推注。治疗效果欠佳者,追加西地兰0.2 mg,同时给予β蛳受体阻滞剂。术后心肺功能良好、心率稳定、年龄偏低者,给予异搏定40 mg或硫氮卓酮10 mg,静脉推注。并用乙胺碘呋酮0.2 g,3次/d,1周后改为0.2 g,1次/d,连续服用0.5 a。结果:患者于术后2 d内转为正常窦性心率者8例(19.0 %),术后1周左右转复为窦性心率者18例(42.9 %),转为慢性心房纤颤者16例(38.0 %)。结论:综合防治心房纤颤的发生,对胸部肿瘤切除术后患者康复具有十分重要的意义。
Objective: To investigate the pathogenesis and prevention of atrial fibrillation after thoracic tumor resection. Methods: A total of 486 patients underwent thoracic tumor resection and 42 patients (8.6%) with atrial fibrillation after operation. Preoperative cardiac dysfunction, rapid heart rate after surgery, frail elderly patients, given cedilanil 0.4 mg ~ 0.6 mg, slow intravenous injection. Treatment of poor results, additional cedilanid 0.2 mg, given β 蛳 receptor blockers. Cardiopulmonary function was good, stable heart rate, lower age, given verapamil 40 mg or diazepam 10 mg, intravenous injection. And with amiodarone 0.2 g, 3 times / d, 1 week later changed to 0.2 g, 1 / d, taking 0.5 a. Results: 8 cases (19.0%) were converted to normal sinus rhythm within 2 days after operation, 18 cases (42.9%) were converted to sinus rhythm at 1 week after operation and converted to 16 cases of chronic atrial fibrillation Example (38.0%). Conclusion: The prevention and treatment of atrial fibrillation is very important for the rehabilitation of patients after thoracic tumor resection.