高龄严重心律失常手术患者麻醉前预置临时心脏起搏器的临床应用  

Clinical application of temporary cardiac pacemaker on elderly patients with severe arrhythmia before anesthesia

作　　者：丁雪娇[1] 史亮[1] 汪承炜[2] 朱凯敏 张庆成[2] 刁宏山 解温品 

机构地区：[1]武警上海总队医院麻醉科,201103 [2]武警上海总队医院心内科,201103

出　　处：《中华灾害救援医学》2015年第11期627-629,共3页Chinese Journal of Disaster Medicine

摘　　要：目的探讨严重心律失常手术患者麻醉前预置临时心脏起搏器的临床应用。方法选取高龄严重心律失常手术患者48例,随机分对照组和观察组。对照组术前未置入临时心脏起搏器,观察组在麻醉手术前预置临时心脏起搏器,记录观察组临时起搏器使用情况,比较两组患者术中心律失常情况,以及术后低血压、低氧血症、感染等并发症情况。结果观察组24例心律失常患者术前成功预置临时心脏起搏器,术中临时起搏器使用率91.6%,与术后48 h相比,差异有统计学意义(Z=-3.951,P<0.001)。观察组心律失常、血压下降、围术期并发症发生率明显低于对照组(P<0.05)。结论严重心律失常手术患者麻醉前预置临时心脏起搏器可稳定循环,减少手术并发症,预后良好,值得推广。Objective To explore the clinical application of temporary cardiac pacemaker on patients with severe arrhythmia before anesthesia. Methods 48 patients with severe arrhythmia were randomly divided into control group and observation group. Temporary cardiac pacemaker was placed on patients in observation group before anesthesia, which was not applied to patients in the control group. The usage of temporary cardiac pacemaker was recorded, and complications like intraoperative arrhythmia, postoperative hypotension, hypoxia and infection of both groups were compared. Results Temporary cardiac pacemakers were successfully placed in the observation group. Its intraoperative use rate was 91.6%, which was statistically significant, when compared with 48 h postoperatively （Z=-3.951, P〈0.001）. The incidence of arrhythmia, lower blood pressure and perioperative complications was significantly lower than that in the control group （P〈0.05）. Conclusions For patients with severe arrhythmia, the placement of temporary cardiac pacemaker before anesthesia can improve circulation, resulting in lower postoperative complications and better prognosis, which is Worthy of clinical application.

关 键 词：严重心律失常 心脏起搏器 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]