冠状动脉介入诊疗术中心脏骤停40例分析  

Clinic analysis of 40 cases with cardiac arrest undergoing coronary angiography or percutaneous coronary intervention

作　　者：糜涛[1] 马业新[1] 曾和松[1] 郭小梅[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院心内科,武汉430030

出　　处：《临床心血管病杂志》2010年第1期19-21,共3页Journal of Clinical Cardiology

摘　　要：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 investigate the reason of cardiac arrest and discuss the measure of prevention and rescue undergoing coronary angiography （CAG） or percutaneous coronary intervention （PCI）. Methods：Correlation factors in patients with cardiac arrest undergoing CAG or PCI were analysed retrospectively. Results：There were 40 cases with cardiac arrest in 4312 patients who were undergone CAG or PCI,including 34 cases with ventricular fibrillation（VF）. The incidence rate of cardiac arrest is 0.93% and that of VF is 0.79%. There were 31 cases with cardiac arrest undergoing CAG or PCI of right coronary artery（RCA）. The patients who were undergone CAG or PCI with ionic contrast media had higher incidence rate of cardiac arrest than that in those with non-ionic contrast media（3.4% VS 0.5%,P〈0.01）. All patients were safe by immediate rescue.Conclusion：Cardiac arrest is easy to observe during CAG or PCI of RCA. It is correlated to the obstruction of RCA flow or coronary artery spasm by catheterization and severe myocardial ischemia. Ionic contrast media could cause cardiac arrest. Sufficient understanding the reason could be necessary to avoid cardiac arrest. Sufficient preparation,timely discovery and immediate rescue should make patients safe.

关 键 词：冠心病 冠状动脉造影 冠状动脉介入治疗 心脏骤停 心室颤动 

分 类 号：R541.4[医药卫生—心血管疾病]