摘要
目的 了解冠状动脉造影 (CAG)推注造影剂对心脏电活动的影响 ,评价ECG改变的临床意义 ,探讨预防或减少并发症的护理措施。方法 在CAG过程中进行持续的心电监测 ,常用的ECG记录导联是Ⅰ、Ⅱ、Ⅲ、avF导联 ,必要时还选用胸导联 ,对用 6 0 %泛影葡胺和欧乃派克 2种造影剂在冠脉造影时引起的心电变化进行观察与护理。结果 当造影剂注入右冠脉后 ,ECG上可出现Ⅱ、Ⅲ、avF导联T波倒置 ,有时还可见窦性心动过缓和动脉血压下降 ,严重时可出现窦性停搏 ,左CAG时ECG变化不如右CAG时明显 ,有时可见T波高尖 ,窦缓和暂时性动脉低血压 ,6 0 %泛影葡胺组明显重于欧乃派克组 ,还可出现房早或室早、短阵室速、房扑或房颤、短阵结性心律及AVB。经过及时处理 ,无严重并发症发生。结论 造影剂发生的这些ECG变化与造影剂的高离子渗透性有关 ,目前多用欧乃派克 ,且严密观察 。
Objective\ To observe the effect of cardial electrical activity on the time of injecting contrast medium in CAG,and elevate the clinic significant of the ECG changement ,and detect the nursing management to prevent or relieve the complication.Methods\ germinant ECG monitoring was used in the process of CAG,usually selecting the I,II,III,avF leads, some times use the theoretic lead if dessert ,observe the ECG changement when injecting two kinds of contrast medium,60% Meglucamine diatrizoate or omnipaque. Results\ T wave reversing ,bradycardia,lower blood pressure can appear when injecting contrast medium in the right coronary artery,and occasionally sinful arrest can appear in severe condition.the ECG changement was not common when injecting contrast medium in left coronary artery,but also can observe the ECG changement ,such as highly T wave.Comparative two kinds of contrast medium,60%Meglucamine diatrizoate,can cause more ECG changement ,and paroxysmal VT, AF, Af and AVB.were usually in this group. Conclusions\ The ECG changement was caused by higher osmose in recent time, using omnipaque and giving special nursing can decline the fatal arrhythmia.
出处
《实用护理杂志》
北大核心
2002年第6期3-4,共2页
Journal of Practical Nursing
