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[鼻填塞引发的鼻心反射(三例报告及文献复习)]

[Nasal-cardiac reflex initiated by nasal packing (three cases report and literature review)].

作者信息

Yang Mingbao, Zhao Hailiang, Lan Jianping, Qiu Shuqi

机构信息

Hospital of Otolaryngology, the Ninth People's Hospital of Shenzhen, Shenzhen Institute of Otolaryngology, Shenzhen, 518120, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Feb;26(3):120-2. doi: 10.13201/j.issn.1001-1781.2012.03.014.

Abstract

OBJECTIVE

To sum up the diagnosis and treatment experience of the nasal-cardiac reflex initiated by postoperative nasal packing.

METHOD

The clinical data of 3 cases with nasal-cardiac reflex initiated by postoperative nasal packing were analyzed retrospectively.

RESULT

In the period of postoperative nasal packing, 3 patients had abruptly drops in heart rate and blood pressure associated with symptoms of autonomic dysfunction such as flustered, chest tightness, tachypnea, body sweating et al. There are no positive signs of pathological significance in the cardiovascular and respiratory system. The reflex had spontaneously to be offset with oxygen, comfort touch therapy, pull out the stuffing, no other special treatment for all cases.

CONCLUSION

The key of the diagnosis for nasal-cardiac reflex is a drop in mean arterial blood pressure (MABP) and the heart rate (HR) more than 20% above the baseline values. The cause of nasal-cardiac reflex initiated by postoperative nasal packing is long-term mechanical pressure on the nasal mucosa and mental factors. Comfort touch therapy and pull out the nasal packing material is effective method to terminate the reflex and the prognosis is good. Correct understanding of the characteristics of the reflex and preventing the occurrence of its adverse consequences have important clinical significance.

摘要

目的

总结术后鼻腔填塞引发鼻心反射的诊治经验。

方法

回顾性分析3例术后鼻腔填塞引发鼻心反射的临床资料。

结果

术后鼻腔填塞期间,3例患者出现心率、血压骤降,并伴有心慌、胸闷、呼吸急促、全身出汗等自主神经功能紊乱症状。心血管及呼吸系统未发现具有病理意义的阳性体征。所有病例经吸氧、安抚触摸治疗、抽出填塞物后反射均自行缓解,无需其他特殊治疗。

结论

鼻心反射的诊断关键是平均动脉血压(MABP)及心率(HR)较基础值下降20%以上。术后鼻腔填塞引发鼻心反射的原因是鼻黏膜长期机械性压迫及精神因素。安抚触摸治疗及抽出鼻腔填塞物是终止反射的有效方法,预后良好。正确认识该反射的特点并预防其不良后果的发生具有重要临床意义。

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