摘要
目的 :探讨年龄对围术期心率变异性的影响及其临床意义。方法 :选择 15 0例择期手术患者 ,以动态心电图 (DCG)监测围术期心率变异性 (HRV)的变化。于术前 1d内监测至少 12h ,术后监测 48h。患者按年龄分为 5组 :A组 :<5 5岁 ,2 3例 ;B组 :5 5～ 64岁 ,2 2例 ;C组 :65～ 69岁 ,41例 ;D组 :70～ 74岁 ,3 6例 ;E组 :≥ 75岁 ,2 8例。结果 :术前TP、LF随年龄的增长呈明显下降趋势 ,B、C、D、E组TP、LF显著低于A组 ,E组HF、D组LF/HF低于A组 ;术后 1d各组HRV各项指标均明显降低 ,B、D、E组TP和B、C、E组HF显著低于A组 ,D、E组LF/HF低于A组 ;术后 2d ,各组HF ,D、E组TP、LF进一步降低 ,D、E组TP、LF/HF显著低于A组。结论 :围术期自主神经功能受损的程度与年龄有一定的关系 ,表现为 :( 1)年龄愈大 ,术前自主神经功能愈低下 ;( 2 )术后高龄患者迷走神经功能降低幅度相对较大 ,迷走
Objective To observe the influence o f age on perioperative heart rate variability (HRV). Methods According to diverse age patients, one hundred and fi fty patients scheduled for elective surgery were divided into five groups. Group A (<55 yr, n=23), Group B (55～64 yr, n=22), Group C (65～69 yr, n= 41), Group D (70～74 yr, n=36) and Group E (≥75 yr, n=28). Perioperativ e HRV of 150 cases were monitored with dynamic electrocardiogram(DMS5.0 Holter, USA) for at least 12 h before and 48 h after surgery. Results Preoperative TP and LF decreased significantly with a ging, Preoperative TP and LF of Group B, C, D, E were lower than Group A, LF/HF of Group D was lower than Group A. HRV of each group in the first day after surg ery decreased significantly, TP of Group B, D, E and HF of Group B, C, E were lo wer than Group A, LF/HF of Group D, E was lower than Group A. In the second day after surgery, HF of each group and TP, LF of Group D, E further decreased, TP o f Group D, E were lower than Group A, LF/HF of Group D, E were lower than Gro up A. Conclusions Perioperative automatic nervous functions are ass o ciated with age. Preoperatively, automatic nervous function is worse and worse w ith aging. Postoperatively, the bigger the age, the worse the decreased vagal ne rvous function and the longer the lasted unbalance of sympathetic to parasympath etic cardiac modulation.
出处
《实用医学杂志》
CAS
2004年第9期1021-1023,共3页
The Journal of Practical Medicine
