体外循环先天性心脏病纠治术对QT离散度的影响及意义  

The Effects of Surgical Correction on QT Dispersion in Patients with Congenital Heart Diseases Undergoing Extracorporeal Circulation

作　　者：周明阳[1] 钟星[1] 何巍[1] 林辉[1] 傅乾昌[1] 彭青云[1] 

机构地区：[1]广西医科大学第一附属医院胸心外科,南宁530021

出　　处：《中国胸心血管外科临床杂志》2000年第1期25-27,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的　研究体外循环心脏不停跳心内直视术纠治先天性心脏病对QT离散度(QTd)的影响及其意义。方法　记录20例先天性心脏病纠治术患者术前、术终和术后7天内同步12导联心电图,测定各时间点QTd值和QT离散度校正值(QTcd)。　结果　术终及术后QTd和QTcd明显升高(P<0.05),术后第2天达最高值,虽然术后第7天仍未能恢复至术前水平,但总体表现为一个缓慢回落的趋势。1例术后频发室性早搏患者及1例术后死于阵发性室性心动过速导致的心跳骤停患者的QTd和QTcd明显高于均值。　结论　体外循环直视手术纠治先天性心脏病患者术终、术后QTd和QTcd明显增高,提示心肌细胞复极受影响,与麻醉及手术操作等有关。Objective\ The effects of surgical correction on QT dispersion(QTd) were studied in patients with congenital heart disease undergoing cardiac surgery on beating heart during extracorporeal circulation. \ Methods\ Electrocardiograms were recorded before, during and 7 days after operation. QTd and corrected value of QT dispersion(QTcd) were measured at each points.\ Results\ The value of QTd and QTcd were obviously rising and came to the peak 2nd day after operation. Although there was a descendant of tendency, the value were still higher than that of the preoperative period( P<0.05) . In one patient who died of arrhythmia and one who suffered from frequent ventricular premature beats, QTd and QTcd were higher than those who recovered smoothly.\ Conclusion (1)QTd in patients with congenital heart disease undergoing cardiac surgery on beating heart rises obviously and perhaps relates to anesthesia and operative damage. (2) QTd may be an useful and valuable indicator in evaluating postoperative arrhythmia and the course of recovery.

关 键 词：体外循环 先天性心脏病 QT离散度 治疗 

分 类 号：R654.2[医药卫生—外科学]