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目的:分析冠状动脉(冠脉)介入诊疗术(冠脉造影及经皮冠脉介入治疗)中发生心脏骤停的原因并探讨防治方法。方法:回顾性分析冠脉介入诊疗术中发生心脏骤停的病例。结果:4312例冠脉介入诊疗术中发生心脏骤停40例,发生率为0.93%,其中心室颤动34例,发生率为0.79%。31例发生于右冠脉介入诊疗术中。使用离子型造影剂的患者较使用非离子型造影剂的患者有较高的心脏骤停发生率(3.4%∶0.5%,P<0.01)。由于抢救及时全部患者均转危为安。结论:心脏骤停易发生于右冠脉介入诊疗术中,与导管进入冠脉口过深阻碍冠脉血流或引起冠脉痉挛、急性心肌缺血等多种因素有关。离子型造影剂可促使心脏骤停的发生。及时发现和处理心脏骤停是防治的关键。
Objective: To analyze the causes of cardiac arrest during coronary intervention (coronary angiography) and percutaneous coronary intervention (PCI) and to explore the methods of prevention and treatment. Methods: A retrospective analysis of cases of cardiac arrest during PCI was performed. Results: Forty-three cases of cardiac arrest occurred in 4312 cases of PCI, the incidence rate was 0.93%. There were 34 cases of ventricular fibrillation, the incidence was 0.79%. 31 cases occurred in the right coronary interventional surgery. Patients who used ionic contrast agents had a higher rate of cardiac arrest (3.4%: 0.5%, P <0.01) than those who used nonionic contrast media. All patients were rescued due to emergency treatment. CONCLUSIONS: Cardiac arrest occurs easily in the right coronary artery interventional therapy. It is related to many factors such as the catheter entering the coronary artery, impeding the coronary blood flow or causing coronary spasm and acute myocardial ischemia. Ionic contrast agents can promote the occurrence of cardiac arrest. Timely detection and treatment of cardiac arrest is the key to prevention and treatment.