直立倾斜试验的严重反应类型及其预防和处理.pdfVIP

1104 职lLll与健康 2ω8 年6 月第24 卷第 11 期 Occup and 日创由 Vol. 24 No.ll lun 2∞8 {晶础也带·相快感蹒崎l阳戚} 直立倾斜试验的严重反应类型 及其预防和处理 蔡清亮 CAI Qing-liang 0 摘要 自的 总结直立倾斜试验的严重反应及其预防和处理。方法试验的倾斜角度为75 ，最快时间为 45 míno 整个过 程持续心电监护，建立良好的静脉通路，身体用护带保护以防意外。结果 共有 36 例接受检查，其中 20 例阳性，10 例出现 严篮反脏，其中2 例有颈内动脉粥样硬化，2 例有惯性扁颤。严3在类型包括:心脏停博5 s 以上4 例，戒严重心功过提心?草率 慢于50 7X/min 达 1 min 以上4 例，戒严意低血压持续 1 min 以上 2 例，所有患者在发生豪厥眉立即放回至平卧位，抬高下 肢;心里郭慢者给阿托晶静脉边射，有 1 例做了胸外按脏，所有患者侵处理意识很快转清，未发生并发症。结论 直立倾斜试 验最为一项无创性检蕉，但严意反应并不少见。严格掌握活应证，术前充分准备和术中密切观察有助于避免意外的发生。 关键词 直立倾斜试验;血管i远走性晕厥;严重反应;预防和处理 中国圄书资料分类号:R443 立献标识码:B 文章编号:1∞4 -1257(2∞8)11-1104-02 Subject SerioωReaction of Tilt Table Test and 118 PrevenlÍon and Treatment Au仙。r CAI Qing-liang (S归昭， Oiu Thefourth Peoples Hospital , Henan , 4761ω， China) Abstract [ Objec创刊] Toωnclude serious reaction of tilt table test and ils preventíon and 阳tment. [Methods] patien恼 were tesled wíth a tilt angle of 75 degrees for a maximum of 45 minutes. Blood pressur白 was monitored during the test and patien18 were protected with a s阱cial bandage. [Results] 20 of 36 cases were defined ωpositive including 10 with serious reaction. Two of the 10 cases had atherosclerosis , and 2 of 由em had chronic atrial fihrillation. Serious types include 4 cωes with cardic arrest of more than 5 second , 4 with severe hradycardia for more than 1 minute and ventricular rate less 由an 50/min , 2 with 1 min ahove sustained seri- ous hypotension. A1l patien18 were tr侃ted by returningω8upine position after 叩lCOpeωcurrence ， intravenous atropine wωgivenω 由e patien恼 wíth slow heart rate , and 1 w.ωtreated by chest compressions. All palien18 resumed sober awareness , and no complica- tionsωcurred after 阳阳lments. [Conclusion] Tougb tilt table les