摘要
冠心病患者行非心脏手术时具有较高的不良心血管事件发生风险,是影响患者预后的重要因素,加强冠心病患者围术期冠状动脉缺血风险识别与管理可以减少患者围术期并发症发生风险。现有评估冠状动脉缺血风险策略各具特点,对冠心病患者进行非心脏手术前缺血风险评估时,应综合患者特点、非心脏手术相关风险、各项检查手段适用范围,选择合适的冠状动脉缺血风险评估策略。对于非心脏手术前是否需要进行冠状动脉血运重建及采用何种血运重建策略,应综合患者临床特点、冠状动脉缺血风险、非心脏手术风险,多学科讨论后决定是否进行血运重建及选择适宜的血运重建方式。本文就冠心病患者非心脏手术围术期风险因素、术前冠状动脉缺血风险评估手段及血运重建策略与选择进行阐述。
Patients with coronary heart disease undergoing non-cardiac surgery have a higher risk of cardiovascular adverse events,which is an important factor affecting patient prognosis.Strengthening the identification and management of coronary artery ischemia risk in perioperative period can reduce the risk of complications.Existing strategies for assessing risk of coronary artery ischemia each have their own characteristics.When evaluating ischemic risk in patients with coronary artery disease before non-cardiac surgery,appropriate risk assessment strategies should be selected based on patient characteristics、non-cardiac surgery-related risks and the applicability of various examination methods.Regarding whether to perform coronary artery revascularization and the appropriate revascularization strategy before non-cardiac surgery,a multidisciplinary discussion should be conducted based on patient clinical characteristics,coronary artery ischemic risk,and non-cardiac surgical characteristics.This article provides a comprehensive review of the risk factors for non-cardiac surgery in patients with coronary heart disease,preoperative risk assessment of coronary artery ischamia,and strategies for revascularizatin.
作者
陈雯雯
王华
CHEN Wen-wen;WANG Hua(Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中国介入心脏病学杂志》
CSCD
2023年第7期547-552,共6页
Chinese Journal of Interventional Cardiology
关键词
冠心病
非心脏手术
血运重建
Coronary heart disease
Non-cardiac surery
Coronary revascularization
