经皮冠状动脉介入术后诱发迷走神经反射的危险因素

Risk factors of vagus nerve reflex after percutaneous coronary intervention

目的:探讨经皮冠状动脉介入术(PCI)诱发迷走神经反射的危险因素。方法:回顾性分析2010年2月至2017年2月成功行PCI的1 362例患者,比较迷走神经反射组和无迷走神经反射组患者的临床资料,多因素logistic回归分析PCI诱发迷走神经反射的危险因素。结果:纳入研究的1 362例患者中有36例患者发生迷走神经反射,血压下降至(56.38±7.32)/(36.85±7.48)mm Hg,心率下降至(45.85±5.65)次/min。迷走神经反射组和无迷走神经反射组患者在既往行经皮冠状动脉介入、留置鞘管、鞘管留置时间、反复穿刺、压迫止血时间、使用桡动脉止血器方面的差异具有统计学意义(P均<0.05)。Logistic回归分析结果显示,PCI术后诱发迷走神经反射的危险因素包括鞘管留置时间及压迫止血时间延长。结论:鞘管留置时间及压迫止血时间延长是PCI诱发迷走神经反射的危险因素。

Objective:To investigate the risk factors of vagal reflex induced by percutaneous coronary intervention(PCI).Methods:The clinical datas of 1 362 patients who underwent PCI during the period from February 2010 to February 2017 were retrospectively analyzed.The clinical datas of patients with and without vagus nerve reflex were compared.Multivariate logistic regression analysis was used to analyze the risk factor of PCI-induced vagal reflex.Results:Vagus nerve reflex occurred in 36 patients enrolled in the study.The blood pressure dropped to(56.38±7.32)/(36.85±7.48)mmHg and the heart rate decreased to(45.85±5.65)beats/min.There were significant differences between the patients with and without vagus nerve reflex in past percutaneous coronary intervention,indwelling sheath,the time of sheath indwelling,repeated puncture and compression hemostasis time(all P<0.05).Logistic regression analysis showed that the risk factors of vagal reflex induced by PCI included the extension of compression hemostasis and the time of sheath indwelling.Conclusions:The time of sheath indwelling and compression hemostasis are risk factors of PCI-induced vagal reflex.