动态心电监护在肝动脉插管栓塞化疗中的应用

Dynamic Electrocardiographic Monitoring During Transcatheter Hepatic Arterial Chemo-embolization

目的:观察经导管肝动脉插管栓塞化疗术中生命体征变化,预防并发症。方法:动态观测87例肝恶性肿瘤患者接受经导管肝动脉造影、化疗、栓塞过程中心率、心电图的变化。结果:全部患者在肝动脉栓塞时都有心率改变和心律改变,其中3例还出现了心血管迷走神经反射,约40.2%患者在肝动脉化疗时有心率改变和心律改变,仅有8%的患者在肝动脉造影时有心率改变和心律改变。结论:肝恶性肿瘤患者在全程动态心电监护下行肝动脉插管栓塞化疗术有利于提高介入治疗安全性。

Objective,.To evaluate the usefulness of dynamic monitoring with electrocardiography （ECG） in patients with hepatocellular carcinomas （HCC） during transcatheter hepatic arterial chemo-embolization. Methods： Eighty-seven patients with HCC accepting transcatheter hepatic arterial angiography,chemotherapy and embolization procedure were dynamically monitored with ECG. The changes of heart rate （HR） and cardiac rhythm were recorded. Results： Abnormal changes of HR and cardiac rhythm were found in all patients during hepatic arterial embolization,and 3 patients had cardiovascular vagus nerve reflex. Thirty-five patients （40.2%） had abnormal HR and cardiac rhythm changes during hepatic arterial chemotherapy. Only 7 patients （8%） had abnormal HR and cardiac rhythm changes during hepatic arterial angiography. Conclusion： Dynamic ECG monitoring can promptly reveal abnormal cardiac electrophysiological changes of patients with HCC during hepatic arterial transcatheter chemo-embolization so as to improve the safety of the interventional therapy.