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无论在心脏手术或非心脏手术中,于麻醉中和麻醉后,单纯因冠状动脉痉挛导致心肌供血不足的病例已屡有报道。这种病例的特点是不伴有心动过速和血压升高所致心肌耗氧量增加,但心电图表现有缺血性改变,多并发心律失常,心肌缺血改善则心律失常消失。本文综述有关资料,对冠状动脉痉挛的病理与发病机制,心电图改变,心律改变,与麻醉有关的预防治疗等问题进行讨论。一、冠状动脉痉挛的病理与发生机制早在20世纪30年代,即发现有一种变异型心绞痛,其特点是可以无任何诱因,于卧位或夜间静息状态下固定时间发作,且发作时常伴发固定导联出现ST段一过性升高。
In both heart surgery and noncardiac surgery, cases of myocardial insufficiency due to coronary artery spasm have been reported frequently after anesthesia and anesthesia. This case is characterized by myocardial tachycardia and increased blood pressure caused by myocardial oxygen consumption increased, but the ECG showed ischemic changes, and more complicated by arrhythmia, myocardial ischemia improved arrhythmia disappeared. This article summarizes the relevant information on the pathological and pathogenesis of coronary artery spasm, ECG changes, changes in heart rhythm, anesthesia-related prevention and treatment and other issues are discussed. First, the pathology and pathogenesis of coronary artery spasm As early as the 1930s, that is, there is a variant of angina, which is characterized by no incentive, in the supine or resting at rest for a fixed time attack, and often accompanied by attacks ST-fixed hair leads a transient increase.