CAJ | 학술논문

目的分析小儿先天性室间隔缺损(VSD)介入治疗后的心电图(ECG)变化,探索避免严重心律失常的发生.方法记录260例介入封堵VSD术前后的ECG,据此分成术后心律失常组和无心律失常组(对照组),对发生完全性或重度房室传导阻滞(AVB)的患儿及时营养心肌和减轻心肌水肿治疗,必要时放置临时起搏器.结果心律失常组82例(31.5%),对照组178例.心律失常组中4例(1.5%)为完全性或重度AVB.36例(13.8%)给予营养心肌等药物处理.两组VSD径比较无显著差异(P>0.05);心律失常组较对照组年龄小,体质量轻(P<0.05),选用封堵器较对照组大(P<0.05).心率、QRS时限、PR间期、QT间期和VTc封堵术前后差异有统计学意义(P<0.05).结论 VSD介入封堵术中和术后需密切注意ECG改变,避免选择过大封堵器.出现完全性右束支传导阻滞(CRBBB)、完全性左束支传导阻滞(CLBBB)、二度AVB者,应尽早营养心肌治疗;完全性或重度AVB者,尽早安装临时起搏器.
목적 분석소인선천성실간격결손(VSD)개입치료후적심전도(ECG)변화,탐색피면엄중심률실상적발생.방법 기록260례개입봉도VSD술전후적ECG,거차분성술후심률실상조화무심률실상조(대조조),대발생완전성혹중도방실전도조체(AVB)적환인급시영양심기화감경심기수종치료,필요시방치림시기박기.결과 심률실상조82례(31.5%),대조조178례.심률실상조중4례(1.5%)위완전성혹중도AVB.36례(13.8%)급여영양심기등약물처리.량조VSD경비교무현저차이(P>0.05);심률실상조교대조조년령소,체질량경(P<0.05),선용봉도기교대조조대(P<0.05).심솔、QRS시한、PR간기、QT간기화VTc봉도술전후차이유통계학의의(P<0.05).결론 VSD개입봉도술중화술후수밀절주의ECG개변,피면선택과대봉도기.출현완전성우속지전도조체(CRBBB)、완전성좌속지전도조체(CLBBB)、이도AVB자,응진조영양심기치료;완전성혹중도AVB자,진조안장림시기박기.
Objective To analysis the change of electrocardiogram(ECG)in the children with congenital ventricular septal defect(VSD)by interventional processes and to explore how to decrease the incidence of serious arrhythmias.Methods To record the ECG before and after interventional closure in the 260 patients that hey were divided into arrhythmia group and no arrhythmia group(control group).The patients were treated with nutrition of cardiac muscle and medicines of reducing the cardiac muscle dropsy when they suffered from complete or serious complete or severe atrioventricuhr block(AVB)even underwent the temporary pacemaker quickly.Results There were 178 csses in control group.82 cuses(31.5%)had arrhythmiag after the interventional,in which 4 cases(1.5%)were complete/serious AVB.36 cases(13.8%)were given medicine above.The age was smaller and the body weigh was less in the arrhythmia group than that of control group(P<0.05).The device occluder was bigger in the arrhythmia group than that of control group(P<0.05.There were significant differences in the comparison of the heart rate,QRS interval,PR interval,QT interval and QTc before and after occlusion in all the cases(P<0.05).Conclusion The changes of ECG have to be taken attention when under-went transcatheter VSD closure using.It is important to avoid the oversized devices.When complete right branch bundle block(CRBBB),complete left branch bundle block(CLBBB)and second AVB occur in the procedure or after that,medicine should be given as early as possible,and once complete/serious AVB has emerged,it is much helpful to perform the temporary pacemaker.All of the cases with arrbythmia should be long-term followed-up.