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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
To investigate the prevention and management of “extubation response” after cardiac sheath removal by cardiac intervention. One hundred and thirteen patients were selected, of whom 810 were treated by retrograde radiofrequency ablation of the artery and 500 were treated by coronary artery (referred to as coronary artery) Group (80 0 cases) and control group (510 cases). Pre-extubation group was given normal saline 10 0 ~ 200ml / h, application 3 ~ 4h, extubation topical application of 1% lidocaine intrathecal infiltration anesthesia; control group without the above treatment directly extubation. Results: Cardiovascular vagal reflex occurred in 10 cases (1.2 5%) in the prevention group and 33 cases (6.47%) in the control group. There was significant difference between the two groups (P <0.01). Conclusion: After cardiovascular intervention, local anesthesia with lidocaine puncture should be applied when the sheath tube is pulled out and infusion of normal saline before extubation can prevent the occurrence of cardiovascular vagal reflex