Perioperative risk reduction measures evidence-based medical evidence.doc

 PAGE \* MERGEFORMAT 4 Perioperative risk reduction measures evidence-based medical evidence The purpose of this article explore the perioperative cardiac risk of the evidence and all evidence of the effectiveness of its conclusion for clinical application of evidence-based medical evidence. Perioperative assessment of risk assessment and medical history and physical examination should begin now to correct cardiac risk index (RCRI) the most effective and easy to remember. With cardiac risk assessment can achieve good results. The most simple is the ECG, high-risk patients found no ECG abnormalities, their increased risk of perioperative twice; while low-risk patients with a normal electrocardiogram, then a lower risk of perioperative period. Two-dimensional echocardiography from many different patients to assess ventricular function that reflects the heart of the risk of poor prognosis in patients with mitral regurgitation prompted, in patients with aortic stenosis will increase the perioperative risk. Exercise electrocardiography the best indicator of preoperative cardiac risk; but in the female patients and that abnormal resting ECG of patients, ST segment depression may be nonspecific. For various reasons can not exercise in patients with coronary artery can be applied to the expansion Across dipyridamole myocardial perfusion imaging (DTI), such as the ventricular muscle perfusion area of more than 30% missing, then the postoperative incidence of cardiovascular accidents was significantly higher. But the DTI a high false negative rate is about dobutamine stress echocardiography (DSE) test more than twice. For the false-negative patients, because of that it is the safe, not effective in those patients with risk reduction measures. As for the false-positive patients was significantly higher proportion of coronary angiography, but does not increase the proportion of coronary revascularization. At present, more and more evidence that dobutamine stress echocard