心肌内心电图在心脏移植术后的临床应用（附5例报告）  

The clinical application of intramyocardium electrocardiography after heart transplantation （Report of 5 cases）

作　　者：解强[1] 杨智翔[2] 应朝辉[2] 耿兴华[2] 

机构地区：[1]中国医科大学附属第四医院心血管外科,辽宁沈阳110032 [2]大连大学附属新华医院心脏外科

出　　处：《中国医师杂志》2008年第6期730-731,共2页Journal of Chinese Physician

摘　　要：目的研究心肌内心电图在监测心脏移植术后排斥反应中的临床应用价值。方法采用双腔法行原位心脏移植手术，术中将电极植入所有病人的右心室心肌内，连接永久起搏器，手术后动态监测患者心肌内心电图QRS波振幅的变化。结果4例患者术后QRS波平均振幅较基数无降低，均长期存活，生活质量良好，1例患者术后第8目死于急性肾衰。结论心肌内心电图可以进行永久无创性监测心脏移植术后排异反应的发生，明显减少心内膜活检次数。Objective To evaluate intra-myocardial electrocardiography （IMEG） for rejection monitoring in transplanted heart. Methods The electrode was anchored in the transplanted right ventricular wall during operation in all patients, and the electrode was connected to the permanent pacemaker to monitor the change of QRS wave in IMEG after the operation. Results The average of R wave amplitude was not decreased after operation in 4 patients who were alive with good quality of life. 1 patient died of acute renal failure 8 days after operation. Conclusion IMEG can be used for long time monitoring the rejection after non invasive heart transplantation and reduce the need of endomyocardial biopsy （ EMB ）.

关 键 词：心脏移植 心电描记术 临床分析 治疗方法 

分 类 号：R654.2[医药卫生—外科学] R540.41[医药卫生—临床医学]