摘要
骨科手术围术期合并心血管疾病患者术后并发症发生率高,病死率高,常影响骨科手术的治疗效果,更影响骨科手术加速康复进程。华西医院骨科从 2012 年开始,逐渐开展骨科加速康复的各项工作,同时在国家卫生健康委员会行业科研专项《关节置换术安全性与效果评价》的支持下,遵循循证医学原则并结合项目组数据库大样本数据分析,华西医院心脏内科、麻醉科和骨科医生对骨科手术围术期并存心血管疾病的评估与处理达成了一致意见,形成了华西医院评估和处理策略。该策略主要内容包括:术前高血压病及靶器官损害、冠状动脉粥样硬化性心脏病 (简称"冠心病") 及心肌供血、心功能及心力衰竭的评估与处理,术中血压、心率及心律、心肌血供的监测与评估,术后血压异常、心绞痛及心肌梗死、心律失常、心力衰竭的评估与处理等方面,供广大骨科医师在临床工作中参考应用。
Patients with cardiovascular disease have higher rates of complications and death after orthopedic surgery,which affects the therapeutic effects as well as the process of enhanced recovery after surgery (ERAS).ERAS started in the orthopedic department of West China Hospital in 2012.Supported by "National Health and Family Planning Commission’s public-benefit project:the safety and effect assessment of joint arthroplasty",evidence-based analysis with large sample database was conducted by experts from cardiology,anesthesiology and orthopedics to compile a strategy and consensus on the evaluation and management of perioperative coexisting cardiovascular disease.Preoperative assessment and management of hypertension and target organ damage,coronary heart disease and myocardial blood supply,cardiac function and heart failure,intraoperative monitoring and evaluation of blood pressure,heart rate / rhythm,myocardial blood supply,postoperative evaluation and management of abnormal blood pressure,angina pectoris/myocardial infarction,arrhythmia,and heart failure after surgery were included in the strategy to provide references for surgeons in clinic.
作者
黄强
廖刃
冯沅
周宗科
徐宏伟
屠重棋
徐原宁
刘浩
杨静
彭勇
江盈盈
周棱
李箭
王光林
康鹏德
陈茂
刘斌
裴福兴
HUANG Qiang;LIAO Ren;FENG Yuan;ZHOU Zong-ke;XU Hong-wei;TU Zhong-qi;XU Yuan-ning;LIU Hao;YANG Jing;PENG Yong;JIANG Ying-ying;ZHOU Leng;LI Jian;WANG Guang-lin;KANG Peng-de;CHEN Mao;LIU Bin;PEI Fu-xing(Department of Orthopedics,West China Hospital of Sichuan University,Chengdu,610041,China)
出处
《中国骨与关节杂志》
CAS
2020年第10期723-729,共7页
Chinese Journal of Bone and Joint
关键词
矫形外科手术
心血管疾病
围手术期
康复
Orthopedic procedures
Cardiovascular diseases
Perioperative period
Rehabilitation
