CAJ | 학술논문

目的:分析冠状动脉(冠脉)介入诊疗术(冠脉造影及经皮冠脉介入治疗)中发生心脏骤停的原因并探讨防治方法.方法:回顾性分析冠脉介入诊疗术中发生心脏骤停的病例.结果:4 312例冠脉介入诊疗术中发生心脏骤停40例,发生率为0.93%,其中心室颤动34例,发生率为0.79%.31例发生于右冠脉介入诊疗术中.使用离子型造影剂的患者较使用非离子型造影剂的患者有较高的心脏骤停发生率(3.4%∶ 0.5%,P<0.01).由于抢救及时全部患者均转危为安.结论:心脏骤停易发生于右冠脉介入诊疗术中,与导管进入冠脉口过深阻碍冠脉血流或引起冠脉痉挛、急性心肌缺血等多种因素有关.离子型造影剂可促使心脏骤停的发生.及时发现和处理心脏骤停是防治的关键.
목적:분석관상동맥(관맥)개입진료술(관맥조영급경피관맥개입치료)중발생심장취정적원인병탐토방치방법.방법:회고성분석관맥개입진료술중발생심장취정적병례.결과:4 312례관맥개입진료술중발생심장취정40례,발생솔위0.93%,기중심실전동34례,발생솔위0.79%.31례발생우우관맥개입진료술중.사용리자형조영제적환자교사용비리자형조영제적환자유교고적심장취정발생솔(3.4%∶ 0.5%,P<0.01).유우창구급시전부환자균전위위안.결론:심장취정역발생우우관맥개입진료술중,여도관진입관맥구과심조애관맥혈류혹인기관맥경련、급성심기결혈등다충인소유관.리자형조영제가촉사심장취정적발생.급시발현화처리심장취정시방치적관건.
Objective:To investigate the reason of cardiac arrest and discuss the measure of prevention and rescue undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). Methods:Correlation factors in patients with cardiac arrest undergoing CAG or PCI were analysed retrospectively. Results:There were 40 cases with cardiac arrest in 4312 patients who were undergone CAG or PCI,including 34 cases with ventricular fibrillation(VF). The incidence rate of cardiac arrest is 0.93% and that of VF is 0.79%. There were 31 cases with cardiac arrest undergoing CAG or PCI of right coronary artery(RCA). The patients who were undergone CAG or PCI with ionic contrast media had higher incidence rate of cardiac arrest than that in those with non-ionic contrast media(3.4% VS 0.5%,P<0.01). All patients were safe by immediate rescue.Conclusion:Cardiac arrest is easy to observe during CAG or PCI of RCA. It is correlated to the obstruction of RCA flow or coronary artery spasm by catheterization and severe myocardial ischemia. Ionic contrast media could cause cardiac arrest. Sufficient understanding the reason could be necessary to avoid cardiac arrest. Sufficient preparation,timely discovery and immediate rescue should make patients safe.