中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2008年
3期
200-202
,共3页
袁沃亮%王景峰%孔敏仪%林永青%聂如琼%刘英梅
袁沃亮%王景峰%孔敏儀%林永青%聶如瓊%劉英梅
원옥량%왕경봉%공민의%림영청%섭여경%류영매
心脏再同步治疗%心力衰竭%并发症
心髒再同步治療%心力衰竭%併髮癥
심장재동보치료%심력쇠갈%병발증
Cardiac resynchronization therapy%Congestive heart failure%Complication
目的 探讨心脏再同步治疗(CRT)术中、术后并发症死亡病例分析.方法 心力衰竭患者50例,男性32例,女性18例,年龄35～79(62.18±13.16)岁,其中扩张性心肌病35例,高血压性心脏病2例,缺血性心肌病10例,三度房室阻滞3例.心功能Ⅲ级(NYHA分级)37例、Ⅳ级13例.植入心脏再同步治疗系统(CRT,含CRT-D),平均随访(22.1±12.8)个月.结果 50例患者中49例成功植入心脏再同步治疗系统,成功率为98%.植入术中、术后相关并发症包括:冠状静脉窦夹层3例(6%),心脏静脉穿孔1例(2%),右心室穿孔1例(2%),膈肌跳动1例(2%);死亡4例,其中围手术期死亡2例.结论 CRT植入术有一定的风险,主要与左心室电极导线的植入过程有关,但亦可能与右心室电极导线相关.应掌握好适应证并作好充分的准备,规范操作,严密观察;同时规范随访和程控,以减少并发症的发生.
目的 探討心髒再同步治療(CRT)術中、術後併髮癥死亡病例分析.方法 心力衰竭患者50例,男性32例,女性18例,年齡35～79(62.18±13.16)歲,其中擴張性心肌病35例,高血壓性心髒病2例,缺血性心肌病10例,三度房室阻滯3例.心功能Ⅲ級(NYHA分級)37例、Ⅳ級13例.植入心髒再同步治療繫統(CRT,含CRT-D),平均隨訪(22.1±12.8)箇月.結果 50例患者中49例成功植入心髒再同步治療繫統,成功率為98%.植入術中、術後相關併髮癥包括:冠狀靜脈竇夾層3例(6%),心髒靜脈穿孔1例(2%),右心室穿孔1例(2%),膈肌跳動1例(2%);死亡4例,其中圍手術期死亡2例.結論 CRT植入術有一定的風險,主要與左心室電極導線的植入過程有關,但亦可能與右心室電極導線相關.應掌握好適應證併作好充分的準備,規範操作,嚴密觀察;同時規範隨訪和程控,以減少併髮癥的髮生.
목적 탐토심장재동보치료(CRT)술중、술후병발증사망병례분석.방법 심력쇠갈환자50례,남성32례,녀성18례,년령35～79(62.18±13.16)세,기중확장성심기병35례,고혈압성심장병2례,결혈성심기병10례,삼도방실조체3례.심공능Ⅲ급(NYHA분급)37례、Ⅳ급13례.식입심장재동보치료계통(CRT,함CRT-D),평균수방(22.1±12.8)개월.결과 50례환자중49례성공식입심장재동보치료계통,성공솔위98%.식입술중、술후상관병발증포괄:관상정맥두협층3례(6%),심장정맥천공1례(2%),우심실천공1례(2%),격기도동1례(2%);사망4례,기중위수술기사망2례.결론 CRT식입술유일정적풍험,주요여좌심실전겁도선적식입과정유관,단역가능여우심실전겁도선상관.응장악호괄응증병작호충분적준비,규범조작,엄밀관찰;동시규범수방화정공,이감소병발증적발생.
Objective To analyze the complications of cardiac resynchronization therapy( CRT) in patients with congestive heart failure. Methods Fifty patients with congestive heart failure were chosen,32 male and 18 female,mean age(62. 18 ± 13. 16)years old. The etiologies of heart disease were dilated eardiomyopathy in 35 ,hypertension eardiomyopathy in 2,3rd AVB in 3 and ischemic myoeardiopathy in 10 ,with New York Heart association(NYHA) class Ⅲ ( n = 37 ) and Ⅳ ( n = 13 ). The patients received CRT implantation, with mean follow-up period(22. 1 ± 12. 8)months. Results Left ventricnlar lead was attempted to implant through coronary sinus for all the 50 patients and the success rate was 98%. Main complications included coronary sinus dissection in 3 patients,coronary vein perforation in 1 patients, right ventricle perforation in 1 patient, phrenic nerve stimulation in 1 patients ;4 patients died. Conclusions It is feasible and safe for implantation of CRT pacing system. However,there were some risk in the procedure. It is relative mainly to the implantation of the coronary sinus lead, but sometimes maybe relative to right ventricle lead. Doctors should take great attention to prevent complications during the implanting procedure and follow-up.
