摘要
目的 探讨胆管压力影响心脏自主神经张力的传导机制。方法 择期胆管T型管引流病人 6 0例分为两组 ,Ⅰ组为胆管术后T型管引流病人 ,胆管内窥镜检查前监测胆管压力 ,并观察加压胆管时心血管反应 ,减压后静注阿托品 2 0 μg/kg ,1 0min后再加压刺激 1次 ;Ⅱ组为连续硬膜外麻醉下胆管引流术病人 (心脏、胆管系统交感神经被阻滞 ) ,观察静注阿托品前、后胆管加压时的心血管反应。结果 Ⅰ、Ⅱ两组胆管加压时平均动脉压、心率均下降。静注阿托品后再加压胆管时 ,Ⅱ组患者心血管反应消失 ,而Ⅰ组其反射仍存在 ,但其程度降低。结论 交感神经与迷走神经共同参与此反射 。
Objective To investigate the machanism through which biliary tract pressure influnces heart autonomic nerve tension.Methods Sixty patients undergoing biliary drainage were divided into two groups.In group Ⅰ,patients with T tube drainage were examined by choledochoscope after choledochotomy.Changes of heart rate and blood pressure were observed during distension of biliary tract.10 minutes after intravenous administration of atropine in a dose of 20 μg/kg,above cardiovascular responses were recorded again.In group Ⅱ,patients underwent T tube drainage under epidural anesthesia in which the levels of blockage reached T 2 L 1.The cardiovascular responses were recorded during biliary tract distension before and after atropine application.Results MAP and HR in both groups were decreased during biliary tract distension( P< 0 05, P< 0 01).After atropine application,cardiovascular reaction disapeared in group Ⅱ during biliary tract distension which was still existed weakly in group Ⅰ.Conclusion Both sympathetic nerve and vagus could contribute to the reflex in human,which differs from that in animals.
出处
《临床麻醉学杂志》
CAS
CSCD
2004年第1期16-17,共2页
Journal of Clinical Anesthesiology
