目的：为探讨经皮二尖瓣球囊成形术(PBMV)患者术中低血压反应的原因及对策。

方法：报告11例PBMV患者，在术中发生低血压反应，血压≤70/50 mmHg(1 mmHg=0.133 kPa),伴头昏、胸闷、出汗。

结果：其中迷走神经反射6例，经静脉注射阿托品纠正；心包出血2例，心包穿刺抽液血压至正常；球囊导管阻塞二尖瓣口1例，缩短导管停留在左心室时间，可以避免低血压反应；快速心房颤动1例，使用西地兰减慢心室率，血压回升；原因不明1例，经使用升压药及阿托品后血压改善。其中1例未完成PBMV，其余10例均获得成功。

结论：PBMV术中发生低血压反应的常见原因是迷走神经张力增高及心包填塞等，通过正确处理可以迅速纠正。

The pathogenesis and Treatment of Hypotension during Percutaneous Balloon Mitral valvuloplasty (Abstract)

Shandong Provincial hospital, Ji′nan(250021), Shandong

zhu Xinglei, Zhang Xinghua, Wang Lei.

objective: To probe the causes and treatment of hypotension during percutaneous balloon mitral valvuloplasty (PBMV).

Methods: eleven patients received PBMV had hypotension (blood pressure≤70/50 mmHg) with dizziness, chest heaviness and sweating.

Results: six patients with vagal reflection were cured by intravenous atropine, 2 with pericardial hemorrhage were treated by pericardiocentesis, 1 patient developed hypotension due to occlusion of the mitral valve orifice by the catheter was corrected by shortening the duration of the catheter in left ventricle, the blood pressure of 1 patient with rapid atrial flutter was elevated by intravenous cedilanid, the blood pressure of 1 patient with hypotension of unknown origin was elevated by vasopressor and atropine. 11 patients except one underwent PBMV successfully.

Conclusion: the most common causes of hypotension during PBMV are vagal reflection and pericardial hemorrhage which can be corrected by proper treatment.