β阻滞药在围手术期的应用演示幻灯片.pptVIP

β阻滞药在围手术期的应用Perioperative Application of β-Adrenergic Receptor Blocker;?-阻滞药治疗高危血管外科的疗效Effect of β-blockor in treating high risk vascular surgery ;;;CABG: 8,482例 ；PTCA: 13,997例一年死亡率统计 (one-year mortality rate)( P0.001 ) ：β－阻滞剂治疗 (group withβ-blocker therapy) ： 12.3% 未β－阻滞剂治疗 (group without β-blocker therapy)： 23.6%冠脉血管重建:β阻滞剂能明显降低一年死亡率; CABG: β-blocker therapy significantly decrease one-year mortality;β－阻滞药围术期心脏的保护作用Heart protective effect of β-blockor in perioperative period;95年开始美托洛尔渐渐成为CABG围术期处理心脏事件的常用药物Metoprolol has been becoming a drug in common use in treating cardiac events in perioperative period since 1995.;临床症状(clinical symptoms) 急性肺水肿，粉红色泡沫样痰 Acute pulmonary edema, pink foaming spittle 高气道压力 High pressure in airway 心电图ST段明显抬高 ST segment elevated significantly in ECG 反复恶性心律失常：室速 室颤 Repeated fatal arrhythmia: ventricular tachycardia, ventricular fibrillation 低血压(SBP70~75mmHg) Hypotension ;治疗经过Therapeutic process;β－阻滞药围术期脑保护作用Brain protective effect of β-blockor in perioperative period;β－阻滞剂治疗的病人，意识模糊、谵妄和一过性缺血发作的发生率为3.9％，未用者为8.2％Among patients using β-blockor , neurological complication : 3.9％; otherwise:8.2％比较2575例CABG的转归证实了术中β－阻滞剂的脑保护作用Prognosis of 2575 cases experiencing CABG demonstrated the brain protective effect of β-blockor administered during operation.;?-阻滞剂降低高危病人手术死亡率β-blockor decreased surgery mortality rate in high risk patients; ?受体阻滞剂组 安慰剂组 P值 β-blockor placebo p value （n=99） （n=101） 总 6个月 0.0% 8.0% 0.001 死 six month 亡 第1年 3.0% 10% =0.005 率 one y