内窥镜逆行胆管造影术中影响心率变异性的因素。

Merete Christensen, Rebekka Reinert, Verner Rasmussen, Svend Schulze, Jacob Rosenberg
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引用次数: 0

摘要

目的:探讨内镜逆行胆管造影(ERCP)时药物、体位和内镜操作对心率变异性的影响。设计:单盲随机试验。研究对象:10名志愿者在三个不同的研究日静脉注射丁莨菪碱、胰高血糖素或生理盐水,10名没有丁莨菪碱或胰高血糖素的ERCP患者。主要观察指标:动态心电图带分析缺血性和心率变异性的变化。结果:丁基东莨菪碱后出现心动过速5例,胰高血糖素后出现心动过速2例。ERCP期间9例发生心动过速,2例发生心肌缺血。丁基东莨菪碱治疗后,迷走神经张力下降,但胰高血糖素或安慰剂治疗后,或ERCP治疗期间,迷走神经张力没有变化。结论:丁基东莨菪碱降低了志愿者迷走神经张力。不使用丁基东莨菪碱的ERCP患者迷走神经张力稳定。因此,先前观察到的ERCP期间迷走神经张力降低可能主要是给予丁基东莨菪碱的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors that affect the variability in heart rate during endoscopic retrograde cholangiopancreatography.

Objective: To find out if drugs, position, and endoscopic manipulation during endoscopic retrograde cholangiopancreatography (ERCP) influence the changes in the variability of heart rate.

Design: Single-blind randomised trial.

Subjects: 10 volunteers given butyscopolamine, glucagon, or saline intravenously on three different study days, and 10 patients who had ERCP without butylscopolamine or glucagon.

Main outcome measures: Holter tape analysis for ischaemia and changes in the variability of heart rate.

Results: 5 volunteers developed tachycardia after butylscopolamine, while 2 developed tachycardia after glucagon. During ERCP 9 patients developed tachycardia, and 2 developed myocardial ischaemia. Vagal tone decreased in the volunteers after butylscopolamine, but no changes were seen after glucagon or placebo, or in patients during ERCP.

Conclusions: Butylscopolamine reduced vagal tone in volunteers. Patients who were having ERCP without butylscopolamine had a stable vagal tone. The previously observed reduced vagal tone during ERCP may therefore be primarily the result of giving butylscopolamine.

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