动态优化起搏系统改善植入者生活质量  

Improvement of life quality in patients with pacemaker by dynamical modified pacing system

作　　者：张代民[1] 刘志华[1] 郭涛[2] 李淑敏[2] 宋建平[1] 蒋庭波[1] 杨向军[1] 蒋文平[1] 

机构地区：[1]苏州大学附属第一医院心脏病科,215006 [2]昆明医学院附属第一医院心脏病科

出　　处：《江苏医药》2008年第4期325-327,共3页Jiangsu Medical Journal

摘　　要：目的探讨动态优化起搏系统改善植入者生活质量的效果及方法学。方法120例接受永久起搏治疗的患者,采用常规心电图、动态心电图、超声心动图、6-min步行测距、生活质量评分等指标,观察起搏系统干预前后的疗效、心功能分级和生活质量变化。结果随访期内实施起搏系统干预共387次,其中调整房室延迟(AVD)61例(含双室起搏16例),调整起搏频率42例;调整感知性能20例;改变起搏模式6例;起搏故障探查5例;心室起搏(VVI)改双腔起搏(DDD)6例;纠治起搏器介导性心动过速3例;持续性房颤加行房室结阻断有效控制心室率6例。优化起搏系统前后,SF-36量表的分值有显著提高(P<0.05)。结论优化起搏系统可确保起搏治疗高效、安全、节能,显著提高患者生活质量;起搏系统优化应坚持提高随访效率,因人、因时而异实施。Objective To observe the outcomes of dynamically adjusting pacemaker parameters and/or pacing hardware during continuous follow-up in the patients with pacemakers. Methods One humdred and twenty patients who were implantated pacemakers were selected. ECG, Holter monitoring electrocardigram, ultrasonic cardiogram, cardiac function, 6-minutes walk, quality of life, were performed for evaluating the effect of treatments and quality of life during follow-up. Results The intervention during follow-up included adjusting AVD in 61 cases （including 16 cases with biventricular pacing）, pacing frequency in 42, sensation （including PMT 3）, checking pacing malfunction in 5 in 20 （including PMT 2）, pacing pattern in 6 cases. Tachycardia induced by pacemaker was reversed in 3 patients. Ventricular rythm was controlled effectively by implanting single chamber pacemakers in 6 patients with permanent atrial fibrillation after atrial ventricular node. The scores of SF-36 were higher after intervention than those before. Conclusion Life quality of patients with pacemakers can be improved by adjusting pacing system individually, timely and reasonably.

关 键 词：生活质量 心脏起搏 

分 类 号：R541[医药卫生—心血管疾病]