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术后七天内,有心肌梗塞史的病人在麻醉与手术后梗塞复发率一般为6%,如果在心肌梗塞3个月后施行麻醉和手术,梗塞复发率约在30%;如在4～6个月后施行,复发率可降到15%。已知梗塞复发的死亡率为50～70%。Steen 等最近检查了36个麻醉和手术期间发生心肌梗塞病例,有8例发生在手术室内,心电图显示出心肌缺血,伴心动过缓与低血压;余28例均见于术后,其中仅11例主诉胸痛,9例首先出现的体症是心跳停止。心肌梗塞的预后至今未得到确切改善,问题因此严重,有必要重新探讨冠状动脉病人麻醉的管理。
Within 7 days after surgery, patients with a history of myocardial infarction generally have a recurrence rate of 6% after anesthesia and surgery. If anesthesia and surgery are performed 3 months after myocardial infarction, the recurrence rate of infarction is about 30% After months of implementation, the recurrence rate can be reduced to 15%. It is known that the mortality rate of infarction recurrence is 50 to 70%. Steen et al recently examined 36 cases of myocardial infarction during anesthesia and surgery, 8 in the operating room, electrocardiogram showed myocardial ischemia, with bradycardia and hypotension; the remaining 28 cases were seen after surgery, of which only 11 The main complaint of chest pain, 9 cases of first signs of illness is a cardiac arrest. The prognosis of myocardial infarction has so far not been exactly improved, the problem is so serious, it is necessary to re-explore the management of coronary artery patients with anesthesia.