心外膜临时起搏器在心脏外科围术期的应用  

Epicardial Application of Temporary Pacemaker in Perioperative Cardiac Surgery

作　　者：郭振平[1] 张喜清[1] 殷春[1] 王永[1] 

机构地区：[1]鄂尔多斯市中心医院心胸血管外科,内蒙古东胜017000

出　　处：《内蒙古医学杂志》2015年第1期36-37,共2页Inner Mongolia Medical Journal

摘　　要：目的探讨心外膜临时起搏器在心脏外科围术期中的应用。方法分析我院心外科1998年6月至2014年3月期间心脏外科手术共56例,其中53例患者在体外循环下行心内直视手术,3例行不停跳冠状动脉旁路移植术,全部患者在手术中安装心外膜临时起搏器,出现窦性心动过缓25例,低心排综合征2例,出现Ⅲ度房室传导阻滞13例,心律失常影响血流动力学稳定6例,其中全心扩大,预防性植入10例。结果全组病例中除5例预防性安装临时起搏器术后心电监测为自主心律,未启用临时起搏器,余51例启用。52例患者恢复自主心律,其中38例为窦性心律,14例为房颤心律,使用临时起搏器时间为6 h^29 d。结论心外膜临时起搏器在心脏手术中应用较为普遍,是治疗心脏外科手术围术期缓慢型心律失常安全有效的方法。是治疗术中Ⅲ度房室传导阻滞、窦性心律过缓有效的措施,也可以起到预防心律失常的作用,是围术期治疗的重要措施。Objective To study the epicardial application of temporary pacemaker in perioperative cardiac surgery. Methods Analysis of our hospital cardiac surgery in June 1998 to March 2014, a total of 56 cases during cardiac surgery, including 53 patients in open - heart surgery under extracorporeal circulation, 3 is not stopped routine coronary artery bypass grafting, all the patients in the surgery to install temporary epicardial pacemaker, 25 cases of sinus bradycardia and cardiac syndrome in 2 cases, appear III degree atrioventricular block 13 cases, arrhythmia influence hemodynamic stability, 6 cases with whole heart to expand, prophylactic implantation of 10 cases. Results In all cases except 5 cases group preventive install temporary pacemaker ecg monitoring for autonomic rhythm of the heart, postoperative temporary pacemaker is not enabled, 51 cases enabled. 52 patients recover autonomic rhythm of the heart, including 38 cases of sinus rhythm, 14 cases of atrial fibrillation rhythm of the heart, use temporary pacemaker time of 6 hours 29 days. Conclusion Epicardial tem- porary pacemaker used in cardiac surgery is relatively common, is the treatment of cardiac surgery perioperative type slow arrhythmia is safe and effective method. Is III in the healing degree atrioventricular block, sinus rhythm slow effective measures that can have the effect of preventing arrhythmia, is one of the important measures to perioperative treatment. Install temporary epicardial pacemaker in cardiac surgery, can maintain normal heart rate, maintain stable hemodynamics, and can win time for medication or install a permanent pacemaker. We in June 1998 to March 2014, during heart surgery use temporary epicardial pacemaker 56 cases of the communist party of China, is now review is as follows.

关 键 词：心外膜临时起搏器 心脏外科围术期 应用 

分 类 号：R654.29[医药卫生—外科学]