[1]刘桂芝)△,常 超),闫书妹),等.斜视矫正术中眼心反射的动态心电图观察[J].郑州大学学报(医学版),2016,(03):386-389.
 LIU Guizhi),CHANG Chao),YAN Shumei),et al.Dynamic electrocardiogram observation of the oculocardiac reflex during strabismus surgery[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2016,(03):386-389.
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斜视矫正术中眼心反射的动态心电图观察()
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2016年03期
页码:
386-389
栏目:
应用研究
出版日期:
2016-05-20

文章信息/Info

Title:
Dynamic electrocardiogram observation of the oculocardiac reflex during strabismus surgery
作者:
刘桂芝1)△常 超1) 闫书妹1) 庆淑梅2) 李志刚3) 朱 豫3)
1)郑州大学第一附属医院物理诊断科 郑州 450052;
2)郑州大学第一附属医院麻醉科 郑州 450052;
3)郑州大学第一附属医院眼科 郑州 450052
Author(s):
LIU Guizhi1) CHANG Chao1) YAN Shumei1) QING Shumei2) LI Zhigang3) ZHU Yu3)
1)Department of Physical Diagnosis,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;
2)Department of Anesthesiology,the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052;
3)Department of Ophthalmology, the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052
关键词:
斜视矫正术 眼心反射 动态心电图
Keywords:
strabismus surgery oculocardiac reflex dynamic electrocardiogram
分类号:
R777.4
摘要:
目的:应用动态心电图(DCG)连续观察并分析斜视矫正术中眼心反射(OCR)的发生特点。方法:借助12导联同步DCG,对68例斜视矫正术(涉及176条眼外肌)中OCR的发生率、发生时机、DCG变化特征、不同眼外肌OCR敏感性、麻醉对心律和OCR的影响、术后恢复情况进行分析。结果:68例眼外肌矫正术中OCR发生率高达94.12%; 勾拉眼外肌时OCR的发生率最高和最为严重; OCR的DCG特征以窦性心律减慢(64.70%)为主,少数(4.55%)出现短暂全心停搏; 3级OCR或全心停搏者均在停止手术操作或给予阿托品后恢复正常窦性心律; OCR均于术后3 h恢复到术前状态。结论:DCG可用于术中OCR的监测。
Abstract:
Aim: To observe the dynamic electrocardiogram(DCG)manifestations of oculocardiac reflex(OCR)during strabismus surgery.Methods: A total of 68 subjects undergoing strabismus surgery were observed by 12-lead synchronous DCG. The incidence, occurring timing, DCG characteristics, the susceptibility in different extraocular muscles of OCR, the affect of anesthesia, and the recovering condition in post-operation were analyzed.Results: The occurrence of OCR was 94.12% among the 68 patients. The OCR had highest occurrence and was severe during hooking extraocular muscles. The most common DCG manifestations of OCR were bradycardia(64.70%)and cardiac arrest(4.55%). All cases of three-grade OCR or those with cardiac arrest recovered to normal sinus rhythm immediately after stopping operation and/or intravenous injecting atropine. All DCG came to normal in postoperative three hours.Conclusion: DCG can accurately observe the occurrence and the severity of OCR during the operation.

参考文献/References:

[1] APT L,ISENBERG S,GAFFNEY WL.The oculocardiac reflex in strabismus surgery[J].Am J Ophthalmol,1973,76(4):533
[2] 董兆,孙建宁.眼科手术与眼心反射[J].东南大学学报(医学版),2007,26(2):148
[3] 诸葛万银,马媛,赵铁良.眼肌手术中的眼心反射[J].中国心血管杂志,2001,6(3):170
[4] 徐帆,曾思明.眼球筋膜囊下麻醉在斜视手术中眼心反射观察[J].临床眼科杂志,2013,21(3):270
[5] LAI YH,HSU HT,WANG HZ,et al.The oculocardiac reflex during strabismus surgery: its relationship to preoperative clinical eye findings and subsequent postoperative emesis[J].J AAPOS,2014,18(2):151
[6] 顾恩华,卢军杰,张抗抗.预设心率报警限降低小儿斜视手术中眼心反射探讨[J].眼科研究,2008,26(11):865
[7] 赵娟.眼心反射的再认识[J].中华实验眼科杂志,2011,29(7):669
[8] OH JN,LEE SY,LEE JH,et al.Effect of ketamine and midazolam on oculocardiac reflex in pediatric strabismus surgery[J].Korean J Anesthesiol,2013,64(6):500
[9] 陈梅.斜视术中不同麻醉方式对眼心反射影响的观察[J].中国斜视与小儿眼科杂志,2009,17(1):6
[10]REED H,MCCAUGHEY T.Cardiac slowing during strabismus surgery[J].Br J Ophthalmol,1962,46(2):112
[11]OHASHI T,KASE M,YOKOI M.Quantitative analysis of the oculocardiac reflex by traction on human extraocular muscle[J].Invest Ophthalmol Vis Sci,1986,27(7):1160
[12]姚静艳,姚菊英,李龙标,等.49例斜视手术眼心反射的临床观察[J].苏州大学学报(医学版),2007,27(3):497
[13]杨红平.斜视矫正手术中心电图的观察[J].中国医药导刊,2012,14(2):215

备注/Memo

备注/Memo:
△女,1962年12月生,博士,副主任医师,研究方向:心肌电生理,E-mail:15838023091@163.com
更新日期/Last Update: 2016-05-20