儿童右室流出道起搏与右室心尖起搏的对比研究  

A comparative study of right ventricular outflow tract pacing and right ventricular apical pacing in children

作　　者：陈晶[1] 曾国洪[2] 曾少颖[2] 王树水[2] 

机构地区：[1]南方医科大学,广州市518001 [2]广东省人民医院,广州市510080

出　　处：《实用医学杂志》2014年第11期1778-1780,共3页The Journal of Practical Medicine

摘　　要：目的:回顾性对比研究儿童行VVI起搏治疗的右室流出道起搏与右室心尖部起搏对近期心功能、QRS波时限及起搏参数的影响。方法:回顾2006年7月至2013年11月,在我科行VVI起搏治疗的38例患儿病例资料,根据术中记录螺旋电极植入的部位分为右室流出道组(n=22)和右室心尖部组(n=16)。记录术前和术后的心脏彩超心功能指标及QRS波时限,术中与术后起搏参数指标进行比较。结果:右室流出道组与右室心尖组在术前及术后心功能指标、术中及术后的起搏阈值差值、导线阻抗差值、R波幅度差值差异无统计学意义。右室流出道起搏组与右室心尖起搏组术后QRS波时限增宽,差异有统计学意义。术前与术后的QRS波时限差值[(134.95±12.86)ms vs(147.44±22.35)ms,t=1.35,P=0.01],差异有统计学意义。结论:儿童右室流出道起搏安全可行,两者起搏术后QRS波时限增宽,但右室心尖起搏组QRS波时限增宽更明显。Objective To compare the impacts of right ventricular outflow tract pacing and right ventricular apical pacing on short-term cardiac function, QRS duration and pacing parameters in children undergoing VVI pacemaker therapy. Methods The clinical data of 38 children undergoing VVI pacemaker treatment in our department from July 2006 to November 2013 were retrospectively reviewed and analyzed to make grouping： 22 with right ventricular outflow tract pacing based on the operational records were assigned in one group and 16 with right ventricular apical pacing as the other group. The two groups were compared in terms of cardiac function indexes, QRS complex width and intra- and post- operative parameters of the implanted pacemakers. Results There were no significant differences between the two groups in pre- and post-operative cardiac function indexes, intra- and post- operative difference in pacing thresholds, pacing wire impedance and R-wave amplitude. The pre- and post-operative QRS duration [ （134.95 ± 12.86）ms vs. （147.44 ±22.35）ms, t = 1.35, P = 0.01 ] was statistically significant between the groups. Conclusion The fight ventrieular outflow tract pacing for children patients is safe and feasible. Although the two pacing approaches achieved lengthened duration of QRS, the right ventrieular outflow tract pacing is more effective in lengthening the duration of QRS.

关 键 词：心脏起搏 人工 右室流出道起搏 右室心尖起搏 心功能指标 起搏参数 

分 类 号：R725.4[医药卫生—儿科]