术前心动过缓患者行阿托品试验的应用价值

Discussion on the value of bradycardia patients with Atropine test in preoperative

目的通过对窦性心动过缓患者阿托品试验的监测,为临床手术安全提供参考。方法对本院2006年3月～2011年8月的415例手术前窦性心动过缓患者进行阿托品试验,静脉注射阿托品2.0mg,1min内注射完毕,观察15～20min心电图变化。结果窦性心动过缓患者415例,行阿托品试验阳性121例,阴性294例,阿托品试验阳性中装起搏器24例,其中>60岁15例,21例装临时起搏器,3例装永久起搏器。结论窦性心动过缓是临床常见的一种心律失常,其中病态窦房结综合征更是增加了此类患者围术期的麻醉风险。阿托品试验是用以诊断病态窦房结综合征(sick sinus syndrome,SSS)的药物试验,是主要方法之一,可初步诊断术前心动过缓患者患病态窦房结综合征的可能,指导临床术前是否安装起搏器,保证手术过程医疗安全。

Objective To monitor Atropine test to patients with sinus bradycardia, and provide a reterence tor the chmcal safety of operation. Methods Four hundred and fifteen patients with sinus bradycardia were given Atropine test before surgery in our hospital from March 2006 to August 2011, intravenous injection of Atropine 2.0 mg was completed within 1 minute, ECG changes was observed for 15-20 min. Results There were 415 patients with sinus bradycardia, Atropine test was positive in 121 cases, negative in 294 cases, patients of Atropine test positive installed pacemaker were 24 cases, who over the age of 60 years in 15 cases, 21 cases of installed temporary pacemaker, 3 cases installed a permanent pacemaker. Conclusion Sinus bradycardia is a common clinical arrhythmia, sick sinus syndrome is an increase of such perioperative anesthetic risk. Atropine test is used for the diagnosis of sick sinus syndrome drug test, which is one of the main method, and can initial diagnosis the disease is sick sinus syndrome in preoperative bradycardia patients, and may guide clinical surgery is installed pacemakers, to ensure the medical safety of surgical procedures.