Sapala等报告手术时心肌梗塞复发率为2.4%与心肌梗塞发生有关的危险因子,及心脏危险指数的计算法详见表1。麻醉时间长短与心肌梗塞的发生率有关,1小时以内手术,发生率1.9%,6小时以上手术发生率16.7%。Knorring报告3小时以内麻醉,非穿透性心肌梗塞7%,穿透性心肌梗塞9%;3小时以上分别为12%。麻醉中低血压是危险因素之一。作者统计165例中无低血压发生,而心肌梗塞非穿透性为7%,穿通性6%,有低血压的48例分别为12%和21%(包括2例心跳停止)。Mauney报告术中收缩压下降30%以上,10分钟以上,术后心肌梗塞发生率为15%,无血压下降者发生率为3.5%。术后心肌梗塞的诊断:典型的自觉症状为胸痛ST段上升、Q波、冠状T等,CPK、SGOT、逸脱酶升高;心阻抗图心室壁运动异常;心肌局灶性坏死;弥漫性血管内凝血(DIC)原因:红细胞压 Sapala and other reports of surgery, myocardial infarction recurrence rate of 2.4% and myocardial infarction risk factors, and cardiac risk index calculation method in Table 1. The duration of anesthesia and the incidence of myocardial infarction, surgery within 1 hour, the incidence of 1.9%, 6 hours or more surgery rate of 16.7%. Knorring reported 7% of anesthesia, non-penetrating myocardial infarction within 3 hours and 9% of penetrating myocardial infarction; 12% over 3 hours. Hypotension in anesthesia is one of the risk factors. The authors enrolled 165 patients without hypotension, whereas myocardial infarction with non-penetrating 7%, penetrating 6%, and hypotensive 48 with 12% and 21% respectively (including 2 with cardiac arrest). Mauney reported a 30% reduction in systolic blood pressure over 10 minutes, a 15% incidence of postoperative myocardial infarction, and a 3.5% reduction in those who did not. Postoperative diagnosis of myocardial infarction: typical symptoms of ST-segment elevation chest pain, Q wave, coronary T, CPK, SGOT, estera elevated enzyme; cardiac impedance map ventricular wall motion abnormalities; myocardial focal necrosis; diffuse blood vessels Internal coagulation (DIC) causes: Erythrocyte pressure