臭氧髓核溶解术中不同臭氧注射速度对患者心脏电生理影响的临床观察  

Cardiac electrophysiological changes in patients underwent different ozone injection rates during ozone nucleolysis

作　　者：李依麦 关星海 周芹[3] Li Yimai;Guan Xinghai;Zhou Qin(Department of Anesthesiology,Huangshi Colored Hospital,Huangshi 435005,Hubei,China;Department of Pain,Puai Hospital,Wuhan Fourth Hospital,Wuhan 430030,Hubei,China;Department of Anesthesiology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]黄石有色医院麻醉科,湖北黄石435005 [2]武汉市第四医院普爱医院疼痛科,湖北武汉430030 [3]武汉大学人民医院麻醉科,湖北武汉430060

出　　处：《中国心脏起搏与心电生理杂志》2024年第5期334-337,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的 观察臭氧髓核溶解术中采用不同臭氧注射速度对患者心脏电生理特性的影响。方法 选择2023年5至12月在武汉市第四医院疼痛科明确诊断为腰椎间盘突出症,拟行经皮穿刺椎间盘臭氧髓核溶解术的患者,采用随机数字表法将患者分为S组和F组,每组30例。所有患者椎间盘内臭氧注射量均为20 ml,臭氧浓度均为40μg/ml。臭氧推注速度S组为0.5 ml/s, F组为1 ml/s,记录两组患者臭氧注射前(T0)、注射时(T1)、注射后5 min时(T2)的心率(HR)、平均动脉压及12导联心电图变化,分析不同时段患者的心脏电生理变化情况。结果 F组T1时较T0时HR减慢(P<0.05);T2时较T1时HR回升(P<0.05);与S组比较,F组T1时HR较低(P<0.05);两组不同时点QT间期、校正QT(QTc)间期、T波峰末(Tp-e)间期、Tp-e/QT比值和心脏电生理平衡指数(iCEB)差异均无统计学意义。结论 臭氧髓核溶解术中臭氧注射速度过快会导致患者的心率一过性下降,术中患者心脏电生理无明显变化,心律失常发生风险较低。Objective To observe the effects of different ozone injection rates on cardiac electrophysiological char-acteristic during ozone nucleolysis.Methods The patients who were diagnosed with lumbar disc herniation at the Pain Department of Wuhan Fourth Hospital from May to December 2023 and planned to undergo percutaneous inter-vertebral disc ozone nucleolysis were selected and divided into group S and group F by random number table method with 30 cases in each group.The injection volume of ozone was 20 ml,the concentration of ozone was 40μg/ml,and the injection speed was set at O.5 ml/s for group S and 1 ml/s for group F.The changes of heart rate(HR),mean arterial pressure and 12-lead electrocardiogram before ozone injection(To),during injection(T1)and 5 min after injection(T2)were recorded in both two groups,and the cardiac electrophysiological changes in patients at dif-ferent periods were analyzed.Results HR in group F decreased at T1(P<O.05)as compared with TO and in-creased at T2 as compared with T1(P<0.05).Compared with group S,HR in group F slowed down at T1(P<0.05).There were no significant differences in QT interval,QTc,Tp-e interval,Tp-e/QT ratio and cardiac electro-physiological balance index(iCEB)between the two groups at different time points.Conclusion The rapid rate of ozone injection during ozone nucleolysis can lead to a transient decrease in the heart rate of patients,and there is no significant change in cardiac electrophysiology during the operation,and the risk of arrhythmia is low.[Chinese Journal ofCardiacPacingand Electrophysiology,2024,38(5):334-337]

关 键 词：心血管病学 心脏电生理 臭氧髓核溶解术 臭氧注射速度 

分 类 号：R331.38[医药卫生—人体生理学]