副交感神经反射的临床观察及处理  

Clinical observation and treatment of the reflex in parasympathetic nerve

作　　者：陈中林[1] 任文烈[1] 吕仕银[2] 黄强[1] 熊高才[1] 

机构地区：[1]大英县人民医院麻醉科,四川大英629300 [2]大英县人民医院胸外科,四川大英629300

出　　处：《临床和实验医学杂志》2007年第10期30-32,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的通过对副交感神经反射的现象进行观察,为临床合并心脏或严重呼吸系统疾患的患者选择麻醉方式提供参考。方法收集部分行椎管内麻醉和全麻完成的腹、盆腔手术病例对术中出现副交感神经反射者,收集其相关病史,辅检记录和临床表现。结果副交感神经反射有较多的临床表现,对心脏影响明显;腹部手术病人两种麻醉方式之间出现副交感神经反射现象有显著差异(P<0.01);盆腔内手术子宫全切、次全切两种麻醉方式之间出现副交感神经反射现象也有显著差异(P<0.01)。结论副交感神经反射表现形式多样,腹部手术中采用椎管内麻醉较全身麻醉发生比例高;盆腔内受周围部副交感神经支配的器官如果椎管内麻醉完善,发生副交感神经反射的比例低于全身麻醉。Objective To provide the referable information for choicing the way of anesthesia for patients complicated with cardiac and respiratory diseases, we observed the phenomenon of reflex of parasympathetic nerve in our clinical practice. Methods Data had been collected from part of cases operated during the period from Jan, 2005 to May, 2007, in which we recorded the symptoms, signs and lab＇s exam/nations and observed the phenomenon of reflex in parasympathetic nerve that happened in operations. Results There were various manifestations in the reflex of parasympathetic nerve, mainly influenced the heart and there was significant difference among the choice of ways of anesthesia, anatomic sites and methods of operation, such as operations in abdomen and in pelvic cavity, and the difference was significant （ P 〈 0.01 ）. Conclusions The manifestations of the reflex of parasympathetic nerve are variable, according to the way of anesthesia. There is higher incidence in combined spinal -epidural block than general anesthesia in abdominal operation, and it is same as in pelvic cavity operation.

关 键 词：临床 观察 副交感神经 处理 

分 类 号：R614[医药卫生—麻醉学]