發(fā)布時(shí)間：2018-03-04 11:34

  本文選題：心臟起搏　切入點(diǎn)：人工　出處：《重慶醫(yī)學(xué)》2017年15期 　論文類型：期刊論文

【摘要】：目的分析慢性阻塞性肺疾病(COPD)合并緩慢型心律失常接受起搏治療的病因、療效、安全性和方法學(xué)特點(diǎn)。方法選擇該院265例接受心臟起搏治療的患者,其中合并COPD的緩慢型心律失�；颊�125例(觀察組),不合并COPD的緩慢型心律失�；颊�140例(對(duì)照組),比較兩組病因、療效、安全性及方法學(xué)。結(jié)果對(duì)照組與觀察組中病態(tài)竇房結(jié)綜合征為95例(68.57%)和68例(54.40%);觀察組的房室傳導(dǎo)阻滯患者[44例(31.5%)]明顯高于對(duì)照組[57例(45.6%)],比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。起搏器植入術(shù)后2周,對(duì)照組中平均心率、最慢心率、左室收縮功能顯著提高,左房、右房、左室舒張內(nèi)徑、右室舒張內(nèi)徑和右室收縮壓顯著縮小,與術(shù)前比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后觀察組中平均心率、最慢心率、右室舒張內(nèi)徑、左室收縮功能和右室收縮壓等指標(biāo)與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組手術(shù)時(shí)間長(zhǎng)于對(duì)照組,靜脈穿刺術(shù)、心房電極調(diào)整數(shù)、心室電極調(diào)整數(shù)與對(duì)照組相比均有增加(P0.05)。再入院率觀察組較高,兩組患者的病因分布比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組右室電極位置分布比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論 COPD合并緩慢型心律失常以病態(tài)竇房結(jié)綜合征為主要類型,心臟起搏器植入對(duì)其治療有效,右室心尖部是較優(yōu)的起搏部位,相對(duì)于不合并COPD的患者,其手術(shù)難度較大。
[Abstract]:Objective to analyze the patients with chronic obstructive pulmonary disease (COPD) clinical etiology, combined with bradyarrhythmia received pacing therapy, the characteristics of safety and methods of 265 cases undergoing cardiac pacing therapy in patients with COPD, including 125 patients with slow arrhythmia patients (observation group), with 140 slow type arrhythmia in patients with COPD patients (control group), compared with two groups of curative effects, etiology, safety and methodology. The control group and the observation group in sick sinus syndrome was 95 cases (68.57%) and 68 cases (54.40%); observation of atrioventricular block patients with [44 group was significantly higher than that (31.5%)] the control group [57 (45.6% cases), the difference was statistically significant (P0.05). 2 weeks after the implantation of pacemaker, the average heart rate in the control group, the heart rate, left ventricular systolic function improved significantly, left atrium, right atrium, left ventricular diastolic diameter, right ventricular diastolic diameter and right ventricular systolic pressure was significantly reduced Small, compared with the preoperative differences were statistically significant (P0.05). After the operation in the observation group, the average heart rate, slow heart rate, right ventricular diastolic diameter, systolic function and right ventricular systolic pressure and left ventricular index operation before the difference was statistically significant (P0.05). The operation time of the observation group than in control group, intravenous puncture atrial electrode adjustment, ventricular electrode adjustment compared with the control group increased significantly (P0.05). The readmission rate of observation group was higher, there was significant difference between the etiology of two groups of patients (P0.05). The two groups had statistical significance of right ventricular electrode position distribution difference (P0.05). Conclusion COPD combined with slow type of arrhythmia in sick sinus syndrome is the main type of pacemaker implantation, effective treatment of the right ventricular apical pacing site is better, compared with patients with COPD, the operation is very difficult.

【作者單位】： 云南省第一人民醫(yī)院老年病科;
【分類號(hào)】：R541.7;R563.9

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