原发性肝癌介入治疗术中迷走神经反射的防治  

Prevention and treatment of vasovagal reactions occurring during TACE therapy for primary liver cancer

作　　者：徐松[1] 朱林忠[2] 朱旭[2] 

机构地区：[1]云南省第二人民医院放射科,昆明650021 [2]北京大学肿瘤医院暨北京市肿瘤防治研究所介入治疗科,恶性肿瘤发病机制及转化研究教育部重点实验室

出　　处：《介入放射学杂志》2014年第12期1077-1080,共4页Journal of Interventional Radiology

摘　　要：目的探讨原发性肝癌介入治疗中迷走反射发生的原因,预防及治疗方法。方法回顾性分析北京肿瘤医院2010年9月—2012年9月原发性肝癌患者在介入治疗中出现迷走反射患者的临床资料。结果 823例原发性肝癌患者行介入治疗过程中出现迷走反射者32例,占3.9%,患者出现胸闷,心率、血压下降,心电图表现为各种心律失常,严重者发生昏迷及死亡;迷走反射的出现与患者的基础状况、肿瘤部位、动脉的解剖及术者的操作关系密切。结论肝癌介入治疗期间,迷走反射可危及患者生命,须充分认识其表现及处置措施,降低迷走反射的严重后果。Objective To investigate the causes, prevention and management of vasovagal reactions occurring during transcatheter arterial chemoembolization （TACE） for primary liver cancer. Methods A total of 823 patients with primary liver cancer, who were admitted to Beijing Cancer Hospital during the period from September 2010 to September 2012 to receive interventional treatment, were enrolled in this study. The clinical data of 32 patients who developed vasovagal reactions during interventional treatment were retrospectively analyzed. Results Of the 823 cases with primary liver cancer, 32 （3.89%） developed vasovagal reactions during the performance of the interventional procedure. The patients complained of chest tightness, and both the heart rate and blood pressure dropped. The electrocardiogram showed various arrhythmias, and coma or death could occur in severe cases. The occurrence of vasovagal reactions was closely related to the patient＇s clinical condition, the distribution of the tumor, arterial anatomy and operator＇s manipulation. Conclusion During the performance of interventional procedure for liver cancer, the occurrence of vasovagal reactions can directly endanger the patient＇s life. The clinical physicians should have a full recognition of its manifestations and a full knowledge of its treatment so as to reduce the serious consequences of vasovagal reactions. （J Intervent Radiol, 2014, 23： 1077-1080）

关 键 词：肝癌 TACE 迷走反射 

分 类 号：R735.7[医药卫生—肿瘤]