摘要
目的探讨冠心病介入治疗过程中出现心血管迷走反射的原因及防治措施。方法选取2017年8月—2018年8月我院收治42例行冠心病介入治疗患者为研究的对象,其中,有8例发生心血管迷走反射,回顾性分析总结发生心血管迷走反射患者的基本资料、病发原因、发生时间分布情况及抢救措施。结果 8例发生心血管迷走反射,其中,1例发生于穿刺时,2例发生于植入冠脉支架时,2例发生拔管时,2例发生于拔管后进行压迫止血时,1例发生于拔管后2 h时。对这8例采取局部压力减轻,静脉快速注射多巴胺、阿托品等治疗措施后,8例患者的症状均得到有效控制,并逐渐稳定。结论对冠心病患者行心血管介入术之前和术后进行拔鞘管前、后均应该做好预防措施、急救准备,严密观察患者疾病情况,及时发现心血管迷走反射并做好妥善的急救措施,能有效防止患者发生心血管迷走反射,提高患者抢救成功率。
Objective To investigate the causes of cardiovascular vagal reflex during interventional therapy of coronary heart disease and its preventive and therapeutic measures.Methods From August 2017 to August 2018,42 patients with coronary heart disease treated by interventional therapy in our hospital were selected as the subjects of study.Of them,8 patients had cardiovascular vagal reflex.The basic data,causes,occurrence time distribution and rescue measures of patients with cardiovascular vagal reflex were retrospectively analyzed and summarized.Results Cardiovascular vagal reflex occurred in 8 cases,including 1 case at puncture,2 cases at coronary stent implantation,2 cases at extubation,2 cases at compression hemostasis after extubation,and 1 case at 2 hours after extubation.After local pressure relief and rapid intravenous injection of dopamine and atropine,the symptoms of 8 patients were effectively controlled and gradually stabilized.Conclusion Preventive measures and first aid preparations should be made before and after removing sheath tube for patients with coronary artery disease before and after cardiovascular intervention.Close observation of patients'disease,timely detection of cardiovascular vagus reflex and proper first aid measures can effectively prevent patients from having cardiovascular vagus reflex and improve the success rate of rescue.
作者
徐业成
何婷
胡威
李屏
XU Yecheng;HE Ting;HU Wei;LI Ping(Department of Cardiology,Xiaogan Hospital,Wuhan University of Science and Technology,Xiaogan Hubei 432100,China;Department of Endocrinology,Xiaogan Hospital,Wuhan University of Science and Technology,XiaoganHubei 432100,China)
出处
《中国继续医学教育》
2019年第13期101-103,共3页
China Continuing Medical Education
关键词
冠心病
心血管迷走反射
介入治疗
诱发因素
预防
临床效果
coronary heart disease
cardiovascular vagus reflex
interventional therapy
predisposing factors
prevention
clinical effect
