经皮二尖瓣球囊成形术中低血压反应原因分析及对策(摘要)
作者：朱兴雷 张兴华 王磊
单位：山东省济南市，山东省立医院(250021)
关键词：
目的 目的：为探讨经皮二尖瓣球囊成形术(PBMV)患者术中低血压反应的原因及对策。
方法：报告11例PBMV患者，在术中发生低血压反应，血压≤70/50 mmHg(1 mmHg=0.133 kPa),伴头昏、胸闷、出汗。
结果：其中迷走神经反射6例，经静脉注射阿托品纠正；心包出血2例，心包穿刺抽液血压至正常；球囊导管阻塞二尖瓣口1例，缩短导管停留在左心室时间，可以避免低血压反应；快速心房颤动1例，使用西地兰减慢心室率，血压回升；原因不明1例，经使用升压药及阿托品后血压改善。其中1例未完成PBMV，其余10例均获得成功。
结论：PBMV术中发生低血压反应的常见原因是迷走神经张力增高及心包填塞等，通过正确处理可以迅速纠正。
The Pathogenesis and Treatment of Hypotension during Percutaneous Balloon Mitral Valvuloplasty (Abstract)
Shandong Provincial Hospital, Ji′nan (250021), Shandong
Zhu Xinglei, Zhang Xinghua, Wang Lei.
Objective: To probe the causes and treatment of hypotension during percutaneous balloon mitral valvuloplasty (PBMV).
Methods: Eleven patients received PBMV had hypotension (blood pressure≤70/50 mmHg) with dizziness, chest heaviness and sweating.
Results: Six patients with vagal reflection were cured by intravenous atropine, 2 with pericardial hemorrhage were treated by pericardiocentesis, 1 patient developed hypotension due to occlusion of the mitral valve orifice by the catheter was corrected by shortening the duration of the catheter in left ventricle, the blood pressure of 1 patient with rapid atrial flutter was elevated by intravenous cedilanid, the blood pressure of 1 patient with hypotension of unknown origin was elevated by vasopressor and atropine. 11 patients except one underwent PBMV successfully.
Conclusion: The most common causes of hypotension during PBMV are vagal reflection and pericardial hemorrhage which can be corrected by proper treatment., 百拇医药
单位：山东省济南市，山东省立医院(250021)
关键词：
目的 目的：为探讨经皮二尖瓣球囊成形术(PBMV)患者术中低血压反应的原因及对策。
方法：报告11例PBMV患者，在术中发生低血压反应，血压≤70/50 mmHg(1 mmHg=0.133 kPa),伴头昏、胸闷、出汗。
结果：其中迷走神经反射6例，经静脉注射阿托品纠正；心包出血2例，心包穿刺抽液血压至正常；球囊导管阻塞二尖瓣口1例，缩短导管停留在左心室时间，可以避免低血压反应；快速心房颤动1例，使用西地兰减慢心室率，血压回升；原因不明1例，经使用升压药及阿托品后血压改善。其中1例未完成PBMV，其余10例均获得成功。
结论：PBMV术中发生低血压反应的常见原因是迷走神经张力增高及心包填塞等，通过正确处理可以迅速纠正。
The Pathogenesis and Treatment of Hypotension during Percutaneous Balloon Mitral Valvuloplasty (Abstract)
Shandong Provincial Hospital, Ji′nan (250021), Shandong
Zhu Xinglei, Zhang Xinghua, Wang Lei.
Objective: To probe the causes and treatment of hypotension during percutaneous balloon mitral valvuloplasty (PBMV).
Methods: Eleven patients received PBMV had hypotension (blood pressure≤70/50 mmHg) with dizziness, chest heaviness and sweating.
Results: Six patients with vagal reflection were cured by intravenous atropine, 2 with pericardial hemorrhage were treated by pericardiocentesis, 1 patient developed hypotension due to occlusion of the mitral valve orifice by the catheter was corrected by shortening the duration of the catheter in left ventricle, the blood pressure of 1 patient with rapid atrial flutter was elevated by intravenous cedilanid, the blood pressure of 1 patient with hypotension of unknown origin was elevated by vasopressor and atropine. 11 patients except one underwent PBMV successfully.
Conclusion: The most common causes of hypotension during PBMV are vagal reflection and pericardial hemorrhage which can be corrected by proper treatment., 百拇医药