膜部室间隔缺损介入封堵术心律失常356例  

Arrhythmia of Transcatheter Closure of Ventricular Septal Defect in 356 Children

作　　者：周谨[1] 王震[1] 张密林[1] 解启莲[1] 高蕾[1] 额尔敦高娃[1] 谭惠莲[1] 刘凌[1] 

机构地区：[1]河北医科大学第一医院心内科先天性心脏病诊疗中心,石家庄050031

出　　处：《实用儿科临床杂志》2007年第13期976-977,共2页Journal of Applied Clinical Pediatrics

基　　金：河北省卫生厅2006年度医学适用技术跟踪项目资助(GL200624)

摘　　要：目的探讨室间隔缺损(VSD)介入治疗心律失常的发生及其防治措施。方法对356例先天性心脏病VSD患者在介入治疗术中,术后7d内,3、6和12个月时的心律失常进行记录和分析。结果术中新出现的心律失常有室性心律失常356例,阵发性室上性心动过速12例,右束支传导阻滞15例,左束支传导阻滞4例,窦性停搏2例,窦性心动过缓10例,房室传导阻滞14例,其中Ⅱ度房室传导阻滞2例,Ⅲ度房室传导阻滞4例。术后7d内发生心律失常:房性期前收缩1例,室性期前收缩3例,阵发性室上速2例,完全性右束支传导阻滞6例,完全性左束支传导阻滞5例,Ⅲ度房室传导阻滞4例,2例经股静脉插入人工心脏临时起搏器。术后3～12个月共发现2例新发的完全性右束支传导阻滞。结论心律失常是VSD封堵术的常见并发症;术中操作规范、及时药物治疗可有效减少和避免心律失常发生。Objective To discuss the treatment and prevention of the axrhythmia of 356 cases transcatheter closure of ventricular septal defect（TCVSD）. Methods Cardiograms were recorded and analysed in TCVSD ,7 days ,3 months ,6 months and 12 months after TCVSD from 356 eases of VSD children. Results The arrhythnfia was found in TCVSD ：356 cases of ventricular arrhythinia, 12 cases of paraoxysmal supraventrieular tachycardia, 15 cases of fight bundle - branch block （RBBB） ,4 cases of left bundle - branch block （LBBB） ,2 cases of sinus arrest, 10 cases of sinus bradycardia,14 cases of atfioventricular block（AVB） ,including 2 cases of Ⅱ degree AVB and 4 cases of Ⅲ degree AVB. The arrhythmia found in 7 days after TCVSD ：6 cases of RBBB ,5 eases of LBBB ,2 cases of paraoxysmal supraventricular tachycardia,4 cases of Ⅲ degree AVB, including 2 cases used temporary cardiac pacemaker by femoral vein, 1 case of atrial premature,3 cases of ventricular premature. The arrhythmia was found from 3 to 12 months after TCVSD ：2 cases of RBBB. Conclusion The arrhythmia is one of the familiar complications and it can be reduced and avoid by doing carefully in TCVSD and medicating timely carefully in and after TCVSD.

关 键 词：室间隔缺损 介入治疗 心律失常 

分 类 号：R725.4[医药卫生—儿科]