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目的分析选择性冠状动脉造影(SCA)术中发生心室颤动(VF)的原因及其预防措施。方法回顾性分析3 028例SCA术中发生VF病例。结果用5F Terumo TIG造影导管VF发生率1.26%,高于使用其它造影导管VF的发生率。SCA术中,23例发生VF,三支CA病变5例、双支CA病变2例、RCA近端重度狭窄4例、左主干单支病变5例、RCA发育细小2例、CA无异常1例、前降支重度狭窄并AMI 2例、RCA单支完全闭塞2例。导管超选择进入圆锥支8例、导管插入过深4例、导管在RCA口操作时间较长2例、左主干病变导管在左主干操作时间过长2例、无诱因6例,RCA单支重度狭窄、前降支注入气泡1例。16患者发生VF前首先表现为CA内压力下降,7例发生VF前无CA内压力下降。结论冠脉病变特点器材选择及操作不当是SCA中VF发生的主要原因,充分认识并避免之可防止VF发生。
Objective To analyze the causes and preventive measures of ventricular fibrillation (VF) during selective coronary angiography (SCA). Methods A retrospective analysis of 3 028 cases of SCA occurred in patients with VF. Results The incidence of VF in 5F Terumo TIG catheter was 1.26%, which was higher than that in other contrast catheter. In SCA, 23 patients had VF, 5 CA lesions, 2 CA lesions, 4 RCA severe stenosis, 5 patients with left main branch disease, 2 cases with small RCA, 1 without CA , Severe descending anterior descending artery and AMI in 2 cases, RCA single complete occlusion in 2 cases. Catheter into the conic branch in 8 cases, catheterization in 4 cases too deep, catheter in the RCA port operation time longer in 2 cases, left main trunk catheter in the left main operation time is too long in 2 cases, no incentive in 6 cases, RCA single heavy Narrow, anterior descending artery into the bubble in 1 case. 16 patients with VF before the first manifestation of CA pressure drop in 7 cases before the onset of VF without CA pressure drop. Conclusion The characteristics of coronary artery disease equipment selection and improper operation is the main reason for the occurrence of VF in SCA, fully aware of and avoid to prevent the occurrence of VF.