心脏术后心房颤动研究进展.pdfVIP

中南大学学报（医学版） 2013, 38(8) ; J Cent South Univ (Med Sci) 863 DOI:10.3969/j.issn.1672-7347.2013.08.018 /xbwk/fileup/PDF/201308863.pdf 心脏术后心房颤动研究进展 蒋铂，杨一峰 ( 中南大学湘雅二医院心胸外科，长沙 410011) [ 摘要 ] 术后心房颤动 (postoperative atrial fibrillation ，POAF) 是心脏手术后最常见的并发症，可以引起血流动力学 紊乱，增加住院时间和死亡率。目前认为 POAF 的发生与心肌传导细胞损伤、交感神经系统过度紧张和炎性反应有关。 临床上可以通过术前、术中及术后相关指标预测 POAF 的发生。对于 POAF ，特别是高风险病人，应该以预防为主， 治疗原则是控制心室率、抗凝和转复心律。 [ 关键词 ] 心房颤动；心脏术后并发症；交感神经系统；炎性反应 Research progress of postoperative atrial fibrillation JIANG Bo, YANG Yifeng (Department of Thoracic and Cardiac Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China) ABSTRACT Postoperative atrial fibrillation (POAF) is the most common complication after cardiac surgery, which leads to hemodynamics disorder, prolongs hospitalization and increases mortality. The underlying mechanisms behind POAF are associated with cardiomyocyte injury, sympathetic activation and inflammation. The prediction of POAF is based on correlated index from pre-, intra- and post-surgery. POAF can be treated by rhythm and heart rate control as well as and antithrombotic therapy. KEY WORDS atrial fibrillation; complication of cardiovascular surgery; sympathetic nervous system; inflammation 术后心房颤动 (postoperative atrial fibrillation ， 瓣膜置换手术为 30%~40% ，在冠脉搭桥联合瓣膜 POAF)被定义为术前没有发生持续性和阵发性房颤 置换手术后房颤的发生率更是高达4 0 % ~ 6 0 % [ 2 ] 。 而在术后出现的房颤，是心脏手术后最常见的并 POAF 多发生于心脏术后前5 d ，在24~72 h