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目的:探讨冠状动脉造影发生心室颤动的原因及预防策略。方法:回顾1993年3月-2008年6月10 082例冠脉造影,其中发生心室颤动24例。分析其临床资料、手术过程、器械选择及预后情况。结果:10 082例冠脉造影发生心室颤动24例,发生率为0.23%,经股动脉途径发生率略低于经桡动脉途径发生率(0.19%vs0.28%),但差异无统计学意义(P>0.05),心室颤动多发生于右冠状动脉造影,右冠状动脉的痉挛、阻塞是导致心室颤动发生的主要因素,发生的原因主要是术者经验相对不足,操作不够规范及对心电、动脉压力曲线观察、注意不够。经有效除颤一般均可恢复正常。结论:冠脉造影时经严格操作VF大多可以避免,发生后经及时心肺复苏一般预后良好。
Objective: To investigate the causes of ventricular fibrillation in coronary angiography and its preventive strategies. Methods: A retrospective review of 10 082 coronary angiography between March 1993 and June 2008 was conducted, in which ventricular fibrillation occurred in 24 cases. Analysis of its clinical data, surgical procedures, equipment selection and prognosis. Results: There were 24 cases of ventricular fibrillation in 10 082 coronary angiography, the incidence was 0.23%, the incidence of trans-arterial approach was lower than that of transradial route (0.19% vs 0.28%), but the difference was not statistically significant (P> 0.05), ventricular fibrillation occurred in the right coronary angiography, right coronary artery spasm, obstruction is the main factor leading to ventricular fibrillation, the main reason is the surgeon experience is relatively inadequate, the operation is not standardized and the ECG Arterial pressure curve observation, not enough attention. The general defibrillation can be restored to normal. Conclusion: Coronary angiography can be avoided by the strict operation of the VF, and CPR generally has a good prognosis.