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首页> 外文期刊>Journal of Oral and Maxillofacial Surgery >Electrocardiographic changes in cardiac patients undergoing dental extractions under local anesthesia.
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Electrocardiographic changes in cardiac patients undergoing dental extractions under local anesthesia.

机译：在局部麻醉下接受拔牙的心脏病患者的心电图变化。

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PURPOSE: The purpose of this study was to identify which group of cardiac patients is most at risk when dental extractions are performed under local anesthesia. PATIENTS AND METHODS: Forty cardiac patients who had dental extraction under local anesthesia (Mepivacain HCl three percent) were connected to a Holter monitor for 24 hours starting 1 hour before the procedure. Of the 40 patients, 24 had coronary artery disease, 12 had valvular disease, 3 were being treated with antiarrhythmic drugs, and 1 had malignant arterial hypertension. Sixteen patients were being treated with digoxin. The electrocardiogram was analyzed for the number of premature beats, ST depression, and cardiac rhythm. A mean rate was calculated for the first 2 hours after injecting the local anesthetic and surgical procedure, and for the subsequent 22 hours. RESULTS: All electrocardiographic changes occurred during the first 2 hours after injecting the local anesthetic. When the mean rate of that period was compared with the remaining22 hours, new pathologic signs of arrhythmia, tachycardia, or ST depression were seen in 14 patients (35%). Of these, 12 were being treated with digoxin. CONCLUSION: Patients being treated with digoxin for atrial fibrillation or congestive heart failure are more prone to complications during dental extractions under local anesthesia than other cardiac patients.
机译：目的：本研究的目的是确定在局部麻醉下进行拔牙时哪一组心脏病患者风险最高。患者与方法：40例在局部麻醉下拔牙的盐酸心脏病患者（盐酸米伐卡因3％）在手术前1小时开始与Holter监护仪连接24小时。在40例患者中，有24例患有冠状动脉疾病，12例患有瓣膜疾病，3例接受抗心律不齐药物治疗，1例患有恶性动脉高压。 16例患者正在接受地高辛治疗。分析心电图的早搏次数，ST压抑和心律。在注射局部麻醉和手术程序后的最初2小时以及随后的22小时中计算出平均比率。结果：所有的心电图变化发生在注射局部麻醉剂后的最初2小时内。当将该时期的平均发生率与剩余的22小时进行比较时，在14例患者中发现了新的心律失常，心动过速或ST抑郁的病理征象（35％）。其中有12个正在用地高辛治疗。结论：用地高辛治疗房颤或充血性心力衰竭的患者比其他心脏病患者更容易在局部麻醉下拔牙过程中发生并发症。

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