Using 3 non-invasive tests, abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia. Abnormalities of heart rate responses to the Valsalva maneuver, deep breathing, and standing w...Using 3 non-invasive tests, abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia. Abnormalities of heart rate responses to the Valsalva maneuver, deep breathing, and standing were noted in patients with autonomic neuropathy defect. The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.展开更多
Cardiac autonomic neuropathy(CAN) is a frequent chronic complication of diabetes mellitus with potentially life-threatening outcomes. CAN is caused by the impairment of the autonomic nerve fibers regulating heart rate...Cardiac autonomic neuropathy(CAN) is a frequent chronic complication of diabetes mellitus with potentially life-threatening outcomes. CAN is caused by the impairment of the autonomic nerve fibers regulating heart rate, cardiac output, myocardial contractility, cardiac electrophysiology and blood vessel constriction anddilatation. It causes a wide range of cardiac disorders, including resting tachycardia, arrhythmias, intraoperative cardiovascular instability, asymptomatic myocardial ischemia and infarction and increased rate of mortality after myocardial infarction. Etiological factors associated with autonomic neuropathy include insufficient glycemic control, a longer period since the onset of diabetes, increased age, female sex and greater body mass index. The most commonly used methods for the diagnosis of CAN are based upon the assessment of heart rate variability(the physiological variation in the time interval between heartbeats), as it is one of the first findings in both clinically asymptomatic and symptomatic patients. Clinical symptoms associated with CAN generally occur late in the disease process and include early fatigue and exhaustion during exercise, orthostatic hypotension, dizziness, presyncope and syncope. Treatment is based on early diagnosis, life style changes, optimization of glycemic control and management of cardiovascular risk factors. Medical therapies, including aldose reductase inhibitors, angiotensin-converting enzyme inhibitors, prostoglandin analogs and alpha-lipoic acid, have been found to be effective in randomized controlled trials. The following article includes the epidemiology, clinical findings and cardiovascular consequences, diagnosis, and approaches to prevention and treatment of CAN.展开更多
目的探讨达克罗宁胶浆联合利多卡因表面麻醉应用于抑制甲状腺手术全麻插管时心血管反射的效果。方法采用随机数字表法将100例全麻甲状腺手术患者分为实验组与对照组,各50例。实验组患者口咽部预先含服盐酸达克罗宁胶浆10 m L,气管插管...目的探讨达克罗宁胶浆联合利多卡因表面麻醉应用于抑制甲状腺手术全麻插管时心血管反射的效果。方法采用随机数字表法将100例全麻甲状腺手术患者分为实验组与对照组,各50例。实验组患者口咽部预先含服盐酸达克罗宁胶浆10 m L,气管插管前口咽部、声门下以2%利多卡因5 m L局部喷洒,对照组患者气管插管前口咽部、声门下以2%利多卡因5 m L局部喷洒。记录并比较2组诱导前、利多卡因表麻时、插管后即刻血流动力学指标。结果与对照组相比,实验组插管反应显著更轻微,各时点血流动力学指标显著更稳定,差异有统计学意义(P <0. 01)。结论在甲状腺手术全麻插管时联合运用达克罗宁胶浆与利多卡因表面麻醉,可有效抑制心血管反射,使血流动力学更稳定。展开更多
文摘Using 3 non-invasive tests, abnormalities of cardiovascular reflex function were found in 7 of 15 patients with achalasia. Abnormalities of heart rate responses to the Valsalva maneuver, deep breathing, and standing were noted in patients with autonomic neuropathy defect. The findings are consistent with the hypothesis that an abnormality of vagal function may contribute to the pathogenesis of achalasia.
文摘Cardiac autonomic neuropathy(CAN) is a frequent chronic complication of diabetes mellitus with potentially life-threatening outcomes. CAN is caused by the impairment of the autonomic nerve fibers regulating heart rate, cardiac output, myocardial contractility, cardiac electrophysiology and blood vessel constriction anddilatation. It causes a wide range of cardiac disorders, including resting tachycardia, arrhythmias, intraoperative cardiovascular instability, asymptomatic myocardial ischemia and infarction and increased rate of mortality after myocardial infarction. Etiological factors associated with autonomic neuropathy include insufficient glycemic control, a longer period since the onset of diabetes, increased age, female sex and greater body mass index. The most commonly used methods for the diagnosis of CAN are based upon the assessment of heart rate variability(the physiological variation in the time interval between heartbeats), as it is one of the first findings in both clinically asymptomatic and symptomatic patients. Clinical symptoms associated with CAN generally occur late in the disease process and include early fatigue and exhaustion during exercise, orthostatic hypotension, dizziness, presyncope and syncope. Treatment is based on early diagnosis, life style changes, optimization of glycemic control and management of cardiovascular risk factors. Medical therapies, including aldose reductase inhibitors, angiotensin-converting enzyme inhibitors, prostoglandin analogs and alpha-lipoic acid, have been found to be effective in randomized controlled trials. The following article includes the epidemiology, clinical findings and cardiovascular consequences, diagnosis, and approaches to prevention and treatment of CAN.
文摘目的探讨达克罗宁胶浆联合利多卡因表面麻醉应用于抑制甲状腺手术全麻插管时心血管反射的效果。方法采用随机数字表法将100例全麻甲状腺手术患者分为实验组与对照组,各50例。实验组患者口咽部预先含服盐酸达克罗宁胶浆10 m L,气管插管前口咽部、声门下以2%利多卡因5 m L局部喷洒,对照组患者气管插管前口咽部、声门下以2%利多卡因5 m L局部喷洒。记录并比较2组诱导前、利多卡因表麻时、插管后即刻血流动力学指标。结果与对照组相比,实验组插管反应显著更轻微,各时点血流动力学指标显著更稳定,差异有统计学意义(P <0. 01)。结论在甲状腺手术全麻插管时联合运用达克罗宁胶浆与利多卡因表面麻醉,可有效抑制心血管反射,使血流动力学更稳定。
