CAJ | 학술논문

目的探讨食管贲门癌伴窦性心动过缓术后非特异性心率增长效应的原因和机制。方法总结分析48例食管贲门癌伴窦性心动过缓病员术前、术中、术后的心率变化。结果术后1～7d，心率60～79次/分13例；80～100次/分30例，100次/分以上5例。术后8～14d，60～79次/分26例；80～100次/分22例。结论食管贲门癌伴窦性心动过缓术后发生非特异心率增快效应的原因和机制可能与下列四点有关：①肿块对迷走神经的挤压刺激，使迷走神经兴奋性增强进而引起窦性心动过缓。②术后单侧切断迷走神经使其作用减弱。③交感神经兴奋性相对增强。④手术可能引起血管活性肠肽及降钙素相关基因肽增多。
목적 탐토식관분문암반두성심동과완술후비특이성심솔증장효응적원인화궤제。방법 총결분석48례식관분문암반두성심동과완병원술전、술중、술후적심솔변화。결과 술후1～7d，심솔60～79차/분13례；80～100차/분30례，100차/분이상5례。술후8～14d，60～79차/분26례；80～100차/분22례。결론 식관분문암반두성심동과완술후발생비특이심솔증쾌효응적원인화궤제가능여하렬사점유관：①종괴대미주신경적제압자격，사미주신경흥강성증강진이인기두성심동과완。②술후단측절단미주신경사기작용감약。③교감신경흥강성상대증강。④수술가능인기혈관활성장태급강개소상관기인태증다。
Objective To study the reason and mechanism of post-operativenonspecific heart rate increase effect in esophageal and cardiac carcinoma complicated with sinus bradycardia.Methods We review and analyze heart rate conditions pre-,during and post-operation in 48 cases esophageal and cardiac carcinoma patients complicated with sinus bradycardia.Results 1-7 day after operation,HR 60-79/min in 13 cases,80-100/min 30cases,＞100/min 5 cases.8-14 day after operation,HR 60-79/min 26 cases,80-100/min 22 cases.Conclusion The following may be the reason and mechanism of post-operative non-specific effect:1.the compression and stimulation to Vagus by the neoplasm,excits Vagus,therefore induce sinus bradycardia;2.the operation decrease the exciting of Vagus by cutting on branch of it;3.the exciting of sympathetic nerve increase respectively;4.vasoactive intestinal peptide and calcitomin associated gene peptide may increase after operation.