心脏介入治疗拔鞘管后心血管迷走反射的预防

探讨心脏介入治疗拔除鞘管后“拔管反应”的预防与处理 ,选择 1310例患者 ,其中经动脉逆行射频消融 810例、冠状动脉 (简称冠脉 )介入治疗 5 0 0例 ,随机分为预防组 (80 0例 )和对照组 (5 10例 )。预防组拔管前给予生理盐水 10 0～ 2 0 0ml/h ,应用 3～ 4h ,拔管时局部应用 1%利多卡因于鞘管旁浸润麻醉 ;对照组未经上述处理直接拔管。结果 :预防组心血管迷走反射发生 10例 (1.2 5 % ) ;对照组发生 33例 (6 .4 7% ) ,两组比较 ,差异有显著性 ,P <0 .0 0 1。结论 :心血管介入治疗后 ,拔鞘管时应用利多卡因穿刺点局部浸润麻醉 ,拔管前输注生理盐水可以预防心血管迷走反射发生

Prevention of Cardiovascular Vagal Reaction After Removing Sheath in Cardiovascular Intervention Therapy

To investigate the prophylaxis and treatment of the vagal reaction after sheath removing in coronary intervention or in radiofrequency catheter ablation(RFCA),1310 patients undergone coronary intervention or RFCA were observed in our study,810 of whom received retrograde transaortic RFCA,and the other were treated with PTCA plus stent.They were divided randomly into prevention group and control group.In prevention group,100～200 ml/h saline was given,lasting 3 to 4 hours before removing sheath,and infiltration of 1 per cent lidocaine was used to anesthetize beside the sheath when removing,whereas there was no special handling in the control group.Results:10 patients presented vagal reaction in prevention group(1.25%),however,33 ones did in the control group(6.47%).there was significantly difference between the two groups.Conclusion:That lidocaine infiltrative anesthesia,together with saline infusion,could prevent cardiovascular vagal reaction after sheath removing.