食管贲门癌伴窦性心动过缓术后非特异性心率增快效应的临床研究

 目的　探讨食管贲门癌伴窦性心动过缓术后非特异性心率增长效应的原因和机制。方法　总结分析 48例食管贲门癌伴窦性心动过缓病员术前、术中、术后的心率变化。结果　术后 1～7d,心率 60～ 79次 /分 1 3例 ;80～ 1 0 0次 /分 30例 ,1 0 0次 /分以上 5例。术后 8～ 1 4d,60～ 79次 /分2 6例 ;80～ 1 0 0次 /分 2 2例。结论　食管贲门癌伴窦性心动过缓术后发生非特异心率增快效应的原因和机制可能与下列四点有关 :1肿块对迷走神经的挤压刺激 ,使迷走神经兴奋性增强进而引起窦性心动过缓。 2术后单侧切断迷走神经使其作用减弱。 3交感神经兴奋性相对增强。 4手术可能引起血管活性肠肽及降钙素相关基因肽增多。

Clinical Study of Post-operative Non-specific Heart Rate Increase Effect in Esophageal and Cardiac Carcinoma Complicated with Sinus Bradycardia

Objective To study the reason and mechanism of post|operative nonspecific heart rate increase effect in esophageal and cardiac carcinoma complicated with sinus bradycardia.Methods We review and analyze heart rate conditions pre|,during and post| operation in 48 cases esophageal and cardiac carcinoma patients complicated with sinus bradycardia.Results 1|7 day after operation,HR 60|79/min in 13 cases,80|100/min 30cases,>100/min 5 cases.8|14 day after operation,HR 60|79/min 26 cases,80|100/min 22 cases.Conclusion The following may be the reason and mechanism of post|operative non|specific effect:1.the compression and stimulation to Vagus by the neoplasm,excits Vagus,therefore induce sinus bradycardia;2.the operation decrease the exciting of Vagus by cutting on branch of it;3.the exciting of sympathetic nerve increase respectively;4.vasoactive intestinal peptide and calcitomin associated gene peptide may increase after operation.