Cho E J, Rho T H, Kim H Y, Kim C J, Lee M Y, Jin S W, Park J C, Kim J H, Hong S J, Choi K B
Department of Internal Medicine, St. Paul's Hospital, Catholic University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2000 Dec;15(3):232-5. doi: 10.3904/kjim.2000.15.3.232.
A 17-year-old high school student presented with a history of habitual faintings. On 24-hour Holter monitoring, cardiac asystoles were recorded, the longest lasting approximately 7 or 8 seconds during venipuncture procedures. The asystole associated with venipuncture demonstrated the cardioinhibitory effects of vasovagal reaction with blood-injury phobia. He also had a positive response during head-up tilt test showing hypotension and relative bradycardia after intravenous isoproterenol injection. After administration of oral beta blocker, he did not show further or recurrent cardiac asystole during blood injury procedure on electrocardiographic examination. Venipuncture is the most common invasive medical procedure performed in hospital settings. While venipuncture is considered to be reasonably safe, serious complication may occur even when only a small volume of blood is withdrawn. Therefore, medical personnel should be prepared to provide appropriate care.
一名17岁的高中生有习惯性昏厥病史。在24小时动态心电图监测中，记录到心脏停搏，在静脉穿刺过程中最长持续约7或8秒。与静脉穿刺相关的心脏停搏显示了血管迷走神经反应与血液损伤恐惧症的心脏抑制作用。他在头高位倾斜试验中也有阳性反应，静脉注射异丙肾上腺素后出现低血压和相对心动过缓。口服β受体阻滞剂后，在心电图检查的血液损伤过程中，他未再出现进一步的或复发性心脏停搏。静脉穿刺是医院环境中最常见的侵入性医疗操作。虽然静脉穿刺被认为是相当安全的，但即使只抽取少量血液也可能发生严重并发症。因此，医务人员应做好提供适当护理的准备。
