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,P<0.05),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,P>0.05)。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。
Objective To investigate the prevention and treatment of biliary cardiac reflex in the interventional treatment of obstructive jaundice. Methods Totally 600 patients with obstructive jaundice were selected and divided into group A （without any preventive measures） and group B （with prevention and treatment, injection of atropine）, and each group had 300 cases. The incidence of biliary cardiac reflex was observed in two groups. The relationship between the incidence of bil- iary cardiac reflex and gender, age, ECG abnormalities were analyzed in both groups. The timing of biliary cardiac reflex in interventional surgery was observed. Results The incidence of biliary cardiac reflex in group A was 30.67% （92/300）, which was significantly higher than that in group B （22/300, 7.33 %）, and the difference was statistically significant （Z2 = 53.06, P〈0.05）. But there was no significant difference between group A （4/300, 1.33%） and group B （0） in the inci- dence of severe biliary cardiac reflex （x2 =0. 45, P〈O. 05）. The incidence of biliary cardiac reflex in both groups was not associated with gender （both %=0. 022, P〉0.05）, but the incidence of biliary cardiac reflex in both groups was positively correlated with age and ECG abnormalities （%ag% =0. 593, 0. 229, %Eca =0. 508, 0. 216, all P〈0.05）. The incidence of biliary cardiac reflex was the highest in the balloon catheter on the stenosis or occlusion of the expansion in group A （55. 430/00, 51/92） and group B （63.64%%, 14/22）, which were higher than those of in puncture and angiography （all P〈 0.05）. Conclusion Preoperative injection of atropine can effectively prevent the occurrence of biliary cardiac reflex in inter- ventional therapy, meanwhile the patients＇ own conditions are still need to be attention.
出处
《中国介入影像与治疗学》
CSCD
北大核心
2017年第5期283-286,共4页
Chinese Journal of Interventional Imaging and Therapy
关键词
黄疸
梗阻性
介入治疗
胆心反射
Jaundice, obstructive
Interventional therapy
Biliary cardiac reflex
