儿童先心病介入治疗致血管迷走神经反射观察

Observation and Nursing of Cardiovascular Vasovagal Reflex in Children after Cardiac Intervention Operation

目的探讨儿童先心病介入治疗致血管迷走神经反射的可能因素和预防干预措施。方法通过对2008年1月至2014年1月期间在本院行先心病介入治疗的525例患儿查阅其临床资料，进行回顾性分析，了解发生血管迷走神经反射的原因，总结相应的护理干预措施。结果525例患儿中发生有血管迷走神经反射的有25例，相关因素有：疼痛、精神紧张因素lj4例，按压及强迫体位导致有5例，药物因素3例，血容量不足因素3例；发生时间：穿刺血管即刻发生7例，带血管鞘0．25～1h3例，拔除鞘管即刻13例，拔除血管鞘后0．25～2h2例。通过及时处理，25例患儿均康复，通过实施全方位的预防干预措施其后无同样病例出现。结论先心病介入治疗导致血管迷走神经反射（vasovagal reaction，VVR）发作的因素有多种，术前对患儿认真评估，做好积极的预防和干预措施，可有效避免发作。

Objective To investigate the causes and prevention of cardiovascular vasovagal reflex in children after Cardiac Interven- tion Operation. Methods 215 cases of children who have received the Cardiac Intervention Operation in our department during June, 2009 to June, 2012 were retrospectively analyzed to study the causes of cardiovascular vasovagal reflex and summarize intervention measures in nursing. Results Cardiovascular vasovagal reflex demonstrated in 25 cases with the following causes： 14 cases with pain and tension, 5 cases by press and compulsive position, 3 cases by drugs and 2 cases by hypovolemia. In terms of onset time, 7 cases happens immediately after vessel puncture, 3 cases with vessel sheath, 13 cases immediately after pulling out sheath, 2 cases after put- ting out vessel sheath. All the 25 children recovered after prompt treatment since omnibearing preventative measures were implemen- ted. Conclusion Cardiovascular vasovagal reflex after the Cardiac Intervention Operation results from many factors, therefore can be avoided by serious evaluation and active prevention and treatment.