中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2012年
9期
104-106
,共3页
儿童%电生理学技术,心脏%心动过速,室上性%食管心房调搏术
兒童%電生理學技術,心髒%心動過速,室上性%食管心房調搏術
인동%전생이학기술,심장%심동과속,실상성%식관심방조박술
Childrer%Electrophysiologic techniques,cardic%Tachycardia,supraventricular%Transesophageal atrial pacing
[目的]通过对室上性心动过速(SVT)儿童经心内电生理检查(IEPS)和食管心房调搏术(TEAP)获得的电生理数据进行对比研究,对TEAP电生理参数的可靠性进行合理的评价,为广泛开展小儿无创心脏电生理检查提供科学依据.[方法]对比研究了我院2000年8月至2008年10月住院的27例SVT儿童的TEAP和IEPS的检查结果,男12例,女15例,年龄6～15岁[平均(10.1±2.5)岁],临床均有反复多次的SVT发作史.分别通过TEAP和IEPS方法,测定窦房结恢复时间(SNRT),校正的窦房结恢复时间(CSNRT),窦房结传导时间(SACTc)；以心房分级递增法S1S1测房室结的文氏型阻滞点和2∶1阻滞点；用S1S1程控早搏刺激测心房有效不应期(AERP)、房室前传有效不应期(AVERP).对所有数据采用SPSS软件进行统计学分折.[结果]27例SVT患儿中7例为房室结折返性心动过这(AVNRT),20例为房室折返性心动过速(AVRT),其中左侧旁道(LAP)6例,右侧旁道(RAP)14例；均通过射频消融(RFCA)术进行成功根治.TEAP分型诊断符合率为96.3％.通过TEAP和IEPS分别获得电生理参数,SNRT分别为(912.2±180.3)ms和(930.2±174.9)ms,CSNRT分别为(304.0±79.7)ms和(287.1±63.1)ms,SACTc分别为(84.3±21.8)ms和(94.6 ±23.2)ms,文氏点分别为(182.0±28.1)ms和(187.0 ±24.9)ms,2∶1阻滞点分别为(211.0 ±24.7)ms和(220.0±19.3)ms,AERP分别为(228.0±29.4)ms和(223.5±21.7)ms,AVERP分别为(298.5±71.8)ms和(277.7 ±57.5)ms.对两组数据进行统计学分析,P均＞0.05,差异无统计学意义.[结论]TEAP电生理参数是可靠的,值得在基层儿科临床单位进行广泛应用.
[目的]通過對室上性心動過速(SVT)兒童經心內電生理檢查(IEPS)和食管心房調搏術(TEAP)穫得的電生理數據進行對比研究,對TEAP電生理參數的可靠性進行閤理的評價,為廣汎開展小兒無創心髒電生理檢查提供科學依據.[方法]對比研究瞭我院2000年8月至2008年10月住院的27例SVT兒童的TEAP和IEPS的檢查結果,男12例,女15例,年齡6～15歲[平均(10.1±2.5)歲],臨床均有反複多次的SVT髮作史.分彆通過TEAP和IEPS方法,測定竇房結恢複時間(SNRT),校正的竇房結恢複時間(CSNRT),竇房結傳導時間(SACTc)；以心房分級遞增法S1S1測房室結的文氏型阻滯點和2∶1阻滯點；用S1S1程控早搏刺激測心房有效不應期(AERP)、房室前傳有效不應期(AVERP).對所有數據採用SPSS軟件進行統計學分摺.[結果]27例SVT患兒中7例為房室結摺返性心動過這(AVNRT),20例為房室摺返性心動過速(AVRT),其中左側徬道(LAP)6例,右側徬道(RAP)14例；均通過射頻消融(RFCA)術進行成功根治.TEAP分型診斷符閤率為96.3％.通過TEAP和IEPS分彆穫得電生理參數,SNRT分彆為(912.2±180.3)ms和(930.2±174.9)ms,CSNRT分彆為(304.0±79.7)ms和(287.1±63.1)ms,SACTc分彆為(84.3±21.8)ms和(94.6 ±23.2)ms,文氏點分彆為(182.0±28.1)ms和(187.0 ±24.9)ms,2∶1阻滯點分彆為(211.0 ±24.7)ms和(220.0±19.3)ms,AERP分彆為(228.0±29.4)ms和(223.5±21.7)ms,AVERP分彆為(298.5±71.8)ms和(277.7 ±57.5)ms.對兩組數據進行統計學分析,P均＞0.05,差異無統計學意義.[結論]TEAP電生理參數是可靠的,值得在基層兒科臨床單位進行廣汎應用.
[목적]통과대실상성심동과속(SVT)인동경심내전생리검사(IEPS)화식관심방조박술(TEAP)획득적전생리수거진행대비연구,대TEAP전생리삼수적가고성진행합리적평개,위엄범개전소인무창심장전생리검사제공과학의거.[방법]대비연구료아원2000년8월지2008년10월주원적27례SVT인동적TEAP화IEPS적검사결과,남12례,녀15례,년령6～15세[평균(10.1±2.5)세],림상균유반복다차적SVT발작사.분별통과TEAP화IEPS방법,측정두방결회복시간(SNRT),교정적두방결회복시간(CSNRT),두방결전도시간(SACTc)；이심방분급체증법S1S1측방실결적문씨형조체점화2∶1조체점；용S1S1정공조박자격측심방유효불응기(AERP)、방실전전유효불응기(AVERP).대소유수거채용SPSS연건진행통계학분절.[결과]27례SVT환인중7례위방실결절반성심동과저(AVNRT),20례위방실절반성심동과속(AVRT),기중좌측방도(LAP)6례,우측방도(RAP)14례；균통과사빈소융(RFCA)술진행성공근치.TEAP분형진단부합솔위96.3％.통과TEAP화IEPS분별획득전생리삼수,SNRT분별위(912.2±180.3)ms화(930.2±174.9)ms,CSNRT분별위(304.0±79.7)ms화(287.1±63.1)ms,SACTc분별위(84.3±21.8)ms화(94.6 ±23.2)ms,문씨점분별위(182.0±28.1)ms화(187.0 ±24.9)ms,2∶1조체점분별위(211.0 ±24.7)ms화(220.0±19.3)ms,AERP분별위(228.0±29.4)ms화(223.5±21.7)ms,AVERP분별위(298.5±71.8)ms화(277.7 ±57.5)ms.대량조수거진행통계학분석,P균＞0.05,차이무통계학의의.[결론]TEAP전생리삼수시가고적,치득재기층인과림상단위진행엄범응용.
[Objective] To investigate the accuracy of diagnosis and classitication of supraventricular tachycardia(SVT) by trsnsesophageal atrial pacing (TEAP)and intracardiac electrophysiologic studies ( IEPS)in children,and evaluate the reliability of TEAP.[Methods] [Results]of TEAP and IEPS in 27 patients with SVT were compared.The included patients were hospitalized during the period from Aug.2000 to Oct.2008.Gender:12 males and 15 lemales,age:6-15 years [ mean ( 10.1 ± 2.5 ) years],had a recurrent SVT history.To assess sinus node recovery time ( SNRT),corrected sinus node recovery time ( CSNRT),sinoatrial conduction time (SACTc),effective refractory period(AERP),strioventricular effective refractory period (AVERP)were recorded by TEAP and IEPS.Meantime,enckebach phenomenon block point and 2∶1 block point of atrioventricular node were recorded by S1S1 incremental pacing.All electrophysiological parameters were statistically analyzed with SPSS software.[Results] In 27 cases of SVT,7 cases were atrioventricular nodal reentrant tachycardia( AVNRT),20 cases were atrioventricular reentrant tachycardia(AVRT) ( including 6 cases with left accessory pathway and 14 cases with right accesory pathway).All successful underwent RFCA.The classification diagnosis accuracy rate was 96.3％ in TEAP.And then,we got electrophysiological parameters of IEPS and TEAP,SNRT were ( 912.2 ± 180.3 ) ms and (930.2 ±174.9)ms,CSNRT were(304.0 ±79.7) ms and(287.1 ±63.1) ms,SACTc were(84.3 ±21.8) ms and(94.6 ±23.2)ms,AERP was(228.0 ±29.4)ms and(223.5 ±21.7) ms,AVERP were(298.5 ±71.8) ms and(277.7 ±57.5) ms,Wenckebach phenomenon points were( 1 82.0 ± 28.1 ) ms and ( 187.0 ± 24.9 ) ms,2∶1 block point were (211.0 ±24.7)ms and(220.0 ± 19.3)ms,the P value ＞0.05.[Conclusions] The electrophysiological results of TEAP were reliable.
