原发性三叉神经痛手术中出现窦性心动过缓的临床分析

Clinical analysis of sinus bradycardia occurred in operation for idiopathic trigeminal neuralgia

目的探讨微血管减压术及(或)感觉根选择性切断术治疗原发性三叉神经痛(idiopathic trigminal neural-gia,ITN)术中发生窦性心动过缓的相关因素、预防及治疗措施。方法回顾性分析全麻下行微血管减压术及/或感觉根选择性切断术治疗ITN 67例术中出现窦性心动过缓的情况。结果术中出现5例心律改变(7.46%)均为窦性心动过缓,术中给予阿托品治疗后均有效,术后随访7日至3个月,平均1.5个月,均无心律失常发现。结论导致窦性心动过缓的相关因素有很多,与手术操作及手术方式密切相关,与可能存在的传导通路也有一定相关性,术中及时处理,常对手术影响较小。为减少其发生,应以预防为主。

Objective To explore the relative factors,prevention and treatment measures of sinus bradycardia occurred during mierovascular decompression （MVD） and/or selective rhizotomy of sensory root （SRSR） for idiopathic trigeminal neuralgia （ITN）. Methods The clinical data of 67 cases of ITN undergone MVD and / or SRSR accompanied by intraoperative sinus bradycardia were analyzed retrospectively. Results 5 cases （7.46%） appeared rhythm changes during operation, and were sinus bradycardia. Atropine injection during operation was effective.The followed-up from 7 d to 3 months （averagel.5 months） did not find postoperative arrhythmia. Conclusion There are many relative factors causing sinus bradycardia, which are closely related to operation and method, and also have certain correlation with possible conductive pathway. Timely intraoperative treatment has less influence on operation. In order to reduce its occurrence, should give priority to prevention.