發(fā)布時間：2018-04-30 23:23

  本文選題：黃疸 + 梗阻性　； 參考：《中國介入影像與治療學(xué)》2017年05期

【摘要】：目的探討梗阻性黃疸介入治療中膽心反射的防治方法。方法選取接受治療的梗阻性黃疸患者600例,根據(jù)是否采取防治措施分為A組(無任何防治措施)和B組(有防治措施,術(shù)前注射阿托品),每組300例。觀察兩組膽心反射發(fā)生率,其與性別、年齡、心電圖表現(xiàn)異常的關(guān)系以及膽心反射在介入手術(shù)中發(fā)生的時機。結(jié)果 A組膽心反射發(fā)生率為30.67%(92/300),顯著高于B組(22/300,7.33%),差異有統(tǒng)計學(xué)意義(χ~2=53.06,P0.05),但嚴(yán)重膽心反射發(fā)生率A組(4/300,1.33%)與B組(0)差異無統(tǒng)計學(xué)意義(χ~2=0.45,P0.05)。兩組患者膽心反射發(fā)生率與性別無關(guān)聯(lián)(Φ均=0.022,P均0.05),但兩組患者膽心反射發(fā)生率與年齡和心電圖異常存在正向關(guān)聯(lián)(Φ_(年齡)=0.593、0.229,Φ_(心電圖)=0.508、0.216,P均0.05)。兩組患者均為在球囊導(dǎo)管對狹窄或閉塞部位進行擴張時膽心反射發(fā)生率最高,分別為55.43%(51/92)和63.64%(14/22),顯著高于穿刺和造影時,差異有統(tǒng)計學(xué)意義(P均0.05)。結(jié)論術(shù)前注射阿托品可有效防治介入治療中膽心反射的發(fā)生,同時需要對患者不良自身條件提高警惕。
[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.
【作者單位】： 安鋼職工總醫(yī)院介入科;
【分類號】：R575

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