探讨经皮经肝胆汁引流术迷走神经反射的观察与护理  

Nursing care for vagus reflex in patients receiving percutaneous transhepatic biliary drainage

作　　者：黄景香[1] 许秀芳[2] 曹宏霞[3] 艾宁[1] 李丽[1] 韩丽英[1] 张丽娜[1] 陆艺[1] 郭丽敏[1] 

机构地区：[1]河北医科大学第四医院放射科,石家庄050011 [2]解放军第八五医院南京军区介入放射中心 [3]唐山市工人医院

出　　处：《介入放射学杂志》2014年第11期1014-1017,共4页Journal of Interventional Radiology

摘　　要：目的探讨经皮经肝胆汁引流术(PTBD)迷走神经反射的预防与护理。方法观察103例PTBD患者术前、术中和术后迷走神经反射,对2011年3月—2012年5月DSA引导下行PTBD治疗的未使用阿托品的梗阻性黄疸患者48例(对照组)和2012年6月—2013年7月应用阿托品的处理的梗阻性黄疸患者55例(观察组)进行比较。记录心率、血压,将数据应用SPSS19.0统计学软件处理。结果两组患者心率减慢、血压降低以及支架植入成功率比较差异有统计学意义。结论 PTBD术前、术中和术后能及时发现迷走神经反射,可以及时处理。术前应用阿托品可以预防迷走神经反射的发生,降低手术风险,提高手术安全性,提高患者的手术耐受性,减少手术意外,应予以提倡。Objective To investigate the prevention and nursing of vagus reflex in patients receiving percutaneous transhepatic biliary drainage（PTBD）. Methods DSA- guided PTBD was performed in 103 patients with obstructive jaundice. Of the 103 patients, PTBD was accomplished without use of atropine in 48（March 2011 to May 2012, control group）, and PTBD was carried out with use of atropine in 55（June 2011 to July 2013, study group）. In perioperative period all the patients were kept under close observation for the symptoms of vagus reflex. The heart rate and blood pressure were recorded. The results were statistically analyzed using SPSS19.0 statistic software. Results Statistically significant differences in the reduction of heart rate and blood pressure as well as in success rate of stent implantation existed between the two groups.Conclusion In perioperative period the symptoms of vagus reflex can be promptly observed, and suitable management can be adopted without delay. Preoperative use of atropine can effectively prevent the occurrence of vagus reflex, thus the operation risks can be reduced and the operation safety can be improved. The patient＇s tolerance to surgery is improved and the surgical accident is reduced.

关 键 词：阿托品 迷走神经反射 效果 

分 类 号：R473.5[医药卫生—护理学]