无抽搐电休克麻醉中出现室性心律失常的Logistic回归分析
|
摘要
目的:探讨无抽搐电休克麻醉引发室性心律失常的影响因素。方法:对1 025例精神病患者行无抽搐电休克治疗麻醉时发生室性心律失常的病历资料进行回顾性分析。结果:无抽搐电休克麻醉时,随着患者年龄的增大发生室性心律失常的风险越大,应用丙泊酚麻醉发生室性心律失常的风险小于依托咪酯。经多因素Logistic回归分析,室性心律失常(Y)的回归方程Y=-1.576X2+2.722X6,χ2=18.522,P<0.01。结论:无抽搐电休克治疗麻醉时,患者年龄越大、BMI越大及应用依托咪酯麻醉是引发室性心律失常的高危因素。
Objective:To explore the influencing factors inducing ventricular arrhythmia(VA) during anesthesia for modified electroconvulsive therapy(MECT). Methods:Case histories of 1 025 schizophrenics who developed VA during anesthesia for MECT were retrospectively analyzed. Results:The older,the higher VA risk during anesthesia for MECT was;VA risk by propofol was less than by etomidate. Multifactor logistic regression analyses showed that Y =- 1. 576X2+ 2. 722X6,χ2= 18. 522,P <0.01. Conclusion:High risk factors inducing VA during MECT anesthesia are the older,greater BMI and etomidate anesthesia.
Objective:To explore the influencing factors inducing ventricular arrhythmia(VA) during anesthesia for modified electroconvulsive therapy(MECT). Methods:Case histories of 1 025 schizophrenics who developed VA during anesthesia for MECT were retrospectively analyzed. Results:The older,the higher VA risk during anesthesia for MECT was;VA risk by propofol was less than by etomidate. Multifactor logistic regression analyses showed that Y =- 1. 576X2+ 2. 722X6,χ2= 18. 522,P <0.01. Conclusion:High risk factors inducing VA during MECT anesthesia are the older,greater BMI and etomidate anesthesia.
引文
[1]Kubo T,Horai S,Ando Y,et al.Case of undiagnosed catecholaminergic polymorphic ventricular tachycardia presenting with ventricular fibrillation after administration of succinylcholine during anesthesia for modified electroconvulsive therapy[J].Psychiatry Clin Neurosci,2011,65(4):397.
[2]Koga Y,Mishima Y,Momozaki M,et al.A case of nonsustained ventricular tachycardia immediately following modifiedelectroconvulsive therapy in a depressive patient[J].J Anesth,2011,25(4):595-598.
[3]赵洪祖,杜好瑞,崔二龙.抗精神病药物对精神分裂症无抽搐电休克治疗中出现室性心律失常的影响[J].中国神经精神疾病杂志,2010,36(9):525-528.
[4]中华医学会精神科分会.中国精神障碍分类与诊断标准[M].第3版.济南:山东科学技术出版社,2001:62-75.
[5]刘俊杰,赵俊,主编.现代麻醉学[M].第2版.北京:人民卫生出版社,1996:426-427.
[6]陆再英,钟南山,主编,内科学[M].第7版.北京:人民卫生出版社,2008:204-211.
[7]Abrams R.Electroconvulsive therapy[M].3rd ed.Oxford Vniversity Publisher,1997:11-12.
[8]慈书平,贾世俊,戴煌,等.镇静剂和抗精神病药致心律失常临床研究[J].实用心电学杂志,2008,17(5):350-351.
[9]喻东山,张心保.精神药物所致的心脏不良反应[J].中华精神科杂志,1998,11(3):246.
[10]沈渔邨.精神病学[M].第5版.北京:人民卫生出版社,2009:825-934.
[11]Hoehns JD,Stanford RH,Geraets DR,et al.Torsades de poines associated with chlorpyomazine:case report and review of associated ventricular arrhythmias[J].J Pharmacotherapy,2001,21(7):871-883.
[12]应诗达,老年病人的麻醉[J].中华麻醉学杂志,1997,17(2):126-127.
[13]杨宁,左明章,王国林,等.国产依托咪酯乳剂用于全身麻醉的多中心研究[J].临床麻醉学杂志,2008,24(5):418-420.
[14]周小东,主编.现代电抽搐治疗理论与实践[M].第1版.石家庄:河北科学技术出版社,2004:100-106.
[2]Koga Y,Mishima Y,Momozaki M,et al.A case of nonsustained ventricular tachycardia immediately following modifiedelectroconvulsive therapy in a depressive patient[J].J Anesth,2011,25(4):595-598.
[3]赵洪祖,杜好瑞,崔二龙.抗精神病药物对精神分裂症无抽搐电休克治疗中出现室性心律失常的影响[J].中国神经精神疾病杂志,2010,36(9):525-528.
[4]中华医学会精神科分会.中国精神障碍分类与诊断标准[M].第3版.济南:山东科学技术出版社,2001:62-75.
[5]刘俊杰,赵俊,主编.现代麻醉学[M].第2版.北京:人民卫生出版社,1996:426-427.
[6]陆再英,钟南山,主编,内科学[M].第7版.北京:人民卫生出版社,2008:204-211.
[7]Abrams R.Electroconvulsive therapy[M].3rd ed.Oxford Vniversity Publisher,1997:11-12.
[8]慈书平,贾世俊,戴煌,等.镇静剂和抗精神病药致心律失常临床研究[J].实用心电学杂志,2008,17(5):350-351.
[9]喻东山,张心保.精神药物所致的心脏不良反应[J].中华精神科杂志,1998,11(3):246.
[10]沈渔邨.精神病学[M].第5版.北京:人民卫生出版社,2009:825-934.
[11]Hoehns JD,Stanford RH,Geraets DR,et al.Torsades de poines associated with chlorpyomazine:case report and review of associated ventricular arrhythmias[J].J Pharmacotherapy,2001,21(7):871-883.
[12]应诗达,老年病人的麻醉[J].中华麻醉学杂志,1997,17(2):126-127.
[13]杨宁,左明章,王国林,等.国产依托咪酯乳剂用于全身麻醉的多中心研究[J].临床麻醉学杂志,2008,24(5):418-420.
[14]周小东,主编.现代电抽搐治疗理论与实践[M].第1版.石家庄:河北科学技术出版社,2004:100-106.