冠状动脉搭桥术中钾浓度变化与心律失常关系的评价

贵州医科大学     麻醉与心脏电生理课题组

翻译：安丽   编辑：张中伟  审核：曹莹

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要

背景：冠状动脉旁路移植术(CABG)是治疗冠状动脉疾病的一种方法。冠状动脉搭桥术中心律失常可导致严重的并发症。钾离子浓度是导致此类心律失常的一个因素。本研究旨在探讨冠状动脉旁路移植术中钾浓度的变化与心律失常的关系。

方法：这项描述性横断面研究对在伊朗阿瓦兹Golestan医院ASA分级为I、II和III级患冠心病，并接受冠状动脉搭桥手术的60名患者进行研究。所有患者均行全身麻醉，机械通气控制呼吸。冠状动脉搭桥术中均在体外循环心脏直视下进行。在手术期间的不同时点（术前、麻醉诱导后、体外循环中、体外循环后、进入ICU后）测量血钾水平。记录各时点的平均动脉压(MAP)、血糖、尿素氮(BUN)、肌酐、钙、镁、血红蛋白(Hb)和血钠水平，并记录各种心律失常类型的发生情况。

结果：

患者平均年龄为60.87±7.35岁，其中女性占45%。患者之间没有统计学上的显著差异。其中MAP、血钾、血糖、BUN、肌酐、钙、镁的变化与心律失常的发生率有显著的相关性(P <0.05)。然而，Hb和钠水平与心律失常发生率之间没有显著的关系(P<0.05)。

结论：钾水平的变化会增加心律失常及其并发症的风险。

原始文献来源：Sara Jorairahmadi, Fatemeh Javaherforooshzadeh, Farahzad Jannatmakan, Farhad Soltani and Liah Shidel Zadeh. Evaluation of the Relationship Between Changes in Potassium Concentration and Arrhythmia During Coronary Artery Bypass Grafting Surgery.Anesth Pain Med. 2022 February; 12(1):e121809.

英文原文

Evaluation of the Relationship Between Changes in Potassium

Concentration and Arrhythmia During Coronary Artery Bypass

Grafting Surgery

Abstract

Background: Coronary artery bypass grafting (CABG) surgery is a treatment option for coronary artery diseases. Cardiac arrhythmias during CABG surgery can lead to serious complications. Potassium ion concentration is a factor involved in such arrhythmias.

Objectives: This study aimed to investigate the relationship between potassium concentration and cardiac arrhythmias in CABG surgery.

Methods: This descriptive cross-sectional study was performed on 60 patients with the American Society of Anesthesiologists class I, II, and III undergoing CABG surgery at Golestan Hospital, Ahvaz, Iran. All patients underwent general anesthesia, and ventilator control was achieved by mechanical ventilation. The on-pump method was used for CABG. Potassium levels were measured at several time points during surgery. All cardiac arrhythmias were recorded. Mean arterial pressure (MAP), serum level of potassium, blood

sugar, blood urea nitrogen (BUN), creatinine, calcium, magnesium, hemoglobin (Hb), and sodium were also recorded.

Results: The mean age of the patients was 60.87±7.35 years, and 45% of the subjects were female. Moreover, there was no statistically

signifificant difffference between the patients. There was a signifificant relationship between the changes in MAP, potassium, blood sugar, BUN, creatinine, calcium, and magnesium with the incidence of cardiac arrhythmias (P < 0.05). However, no signifificant relationship was noted between Hb and sodium levels with the incidence of cardiac arrhythmias (P < 0.05).

Conclusions: The changes in potassium levels increase the risk of cardiac arrhythmias and their complications.

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