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目的 探讨食管贲门癌伴窦性心动过缓术后非特异性心率增长效应的原因和机制。方法 总结分析 48例食管贲门癌伴窦性心动过缓病员术前、术中、术后的心率变化。结果 术后 1～7d,心率 60～ 79次 /分 1 3例 ;80～ 1 0 0次 /分 30例 ,1 0 0次 /分以上 5例。术后 8～ 1 4d,60～ 79次 /分2 6例 ;80～ 1 0 0次 /分 2 2例。结论 食管贲门癌伴窦性心动过缓术后发生非特异心率增快效应的原因和机制可能与下列四点有关 :1肿块对迷走神经的挤压刺激 ,使迷走神经兴奋性增强进而引起窦性心动过缓。 2术后单侧切断迷走神经使其作用减弱。 3交感神经兴奋性相对增强。 4手术可能引起血管活性肠肽及降钙素相关基因肽增多。
Objective To investigate the causes and mechanisms of non-specific heart rate increase after esophageal and cardiac cancer with sinus bradycardia. Methods The preoperative, intraoperative and postoperative heart rate changes of 48 patients with esophageal and cardiac cancer complicated with sinus bradycardia were analyzed. Results 1 to 7 days after operation, heart rate was 60 to 79 beats/minute in 13 cases; 80 to 1000 beats/minute in 30 cases, and 100 beats/minute in 5 cases. Postoperative 8 to 14 days, 60 to 79 beats/minute in 26 cases; 80 to 1,000 beats/minute in 22 cases. Conclusion The causes and mechanisms of the non-specific heart rate increase after esophageal and cardiac cancer with sinus bradycardia may be related to the following four points: 1 The stimulating effect of the mass on the vagus nerve stimulates the vasovagal excitability to cause sinus beats. slow. 2 The vagus nerve was unilaterally cut off after surgery. 3 Relatively enhanced sympathetic excitability. 4 Surgery may cause increased vasoactive intestinal peptide and calcitonin related gene peptides.