梗阻性黄疸介入治疗中胆心反射的防治

发布时间：2018-04-30 23:23

本文选题：黄疸 + 梗阻性　；参考：《中国介入影像与治疗学》2017年05期

【摘要】：目的探讨梗阻性黄疸介入治疗中胆心反射的防治方法。方法选取接受治疗的梗阻性黄疸患者600例,根据是否采取防治措施分为A组(无任何防治措施)和B组(有防治措施,术前注射阿托品),每组300例。观察两组胆心反射发生率,其与性别、年龄、心电图表现异常的关系以及胆心反射在介入手术中发生的时机。结果 A组胆心反射发生率为30.67%(92/300),显著高于B组(22/300,7.33%),差异有统计学意义(χ~2=53.06,P0.05),但严重胆心反射发生率A组(4/300,1.33%)与B组(0)差异无统计学意义(χ~2=0.45,P0.05)。两组患者胆心反射发生率与性别无关联(Φ均=0.022,P均0.05),但两组患者胆心反射发生率与年龄和心电图异常存在正向关联(Φ_(年龄)=0.593、0.229,Φ_(心电图)=0.508、0.216,P均0.05)。两组患者均为在球囊导管对狭窄或闭塞部位进行扩张时胆心反射发生率最高,分别为55.43%(51/92)和63.64%(14/22),显著高于穿刺和造影时,差异有统计学意义(P均0.05)。结论术前注射阿托品可有效防治介入治疗中胆心反射的发生,同时需要对患者不良自身条件提高警惕。
[Abstract]:Objective to investigate the prevention and treatment of biliary reflex in interventional treatment of obstructive jaundice. Methods 600 patients with obstructive jaundice received treatment were divided into two groups: group A (without any prevention and treatment) and group B (300 patients in each group were treated with atropine before operation). The incidence of choledochocardial reflex, its relationship with sex, age, abnormal electrocardiogram, and the timing of choledochocardial reflex in interventional operation were observed. Results the incidence of choledochocardial reflex in group A was 30.67 / 92 / 300, which was significantly higher than that in group B (22 / 300 / 7.33). The difference was statistically significant (蠂 ~ (2 / 2) 53.06% P 0.05, but the incidence of severe bravery heart reflex in group A (4 / 300 ~ 1.33) was not significantly different from that in group B (蠂 ~ (22) 0.45) (P 0.05). There was no correlation between the incidence of choledochocardial reflex and sex in the two groups (桅 0.022, P 0.05), but there was a positive correlation between the incidence of choledochocardial reflex and age and abnormal electrocardiogram in the two groups (桅: 0. 593 / 0.229, 桅 (ECG = 0. 508 / 0. 216P, P = 0. 05). The incidence of biliary and cardiac reflex was the highest in both groups (55.4351 / 92) and 63.64 / 14 / 22 (P < 0.05) when the balloon catheter was used to dilate the stenosis or occlusion. Conclusion preoperative injection of atropine can effectively prevent the occurrence of choledochocardial reflex in interventional therapy.
【作者单位】：安钢职工总医院介入科;
【分类号】：R575

【相似文献】