R—R长间歇的发生机制及临床意义探讨  

作　　者：陈旭丽[1] 贺常萍[2] 

机构地区：[1]皖南医学院第二附属医院心电图室,安徽芜湖241000 [2]皖南医学院第二附属医院心内科,安徽芜湖241000

出　　处：《世界中医药》2016年第B06期2123-2124,共2页World Chinese Medicine

摘　　要：目的探讨动态心电图（Holter）检测以窦性心律为主导节律时出现R—R长间歇的发生机制及临床意义。方法：2015年6月一2016年4月在我院行Holter检测的1744例门诊和住院患者中，对R—R长间歇的50例患者进行回顾性分析，通过心电图诊断分析导致R—R长间歇的各种发生机制。结果：R—R长间歇在Holter检测中的总发病率为2．8％，以老年人群为主，60岁以上患者占86％，病因最多见于房早未下传（32％），窦性停搏（24％），其他可见于二度及高度房室阻滞，阵发性房速、房颤、房扑终止后，室早后代偿等。随访结果：内科保守治疗后R—R长间歇消失28例，明显减少9例；植入心脏起搏器4例；拒绝起搏器治疗，内科治疗效果不佳者4例；随访不详者5例。结论：Holter可以及时检测出长R—R间歇并分析其发生原因，能够及时发现需要植入永久性心脏起搏器的患者，对临床疾病的诊断和治疗具有极大的指导意义。Objective To explore the mechanism and cilinicai application of R-R long intermittent dominated by sinus rhythm by the dynamic electrecardiogram（Holter）.Methods：1744 cases of patients detected by Halter in our hospital from June 2015 to April 2016, analyzed retrospectively various reasons of 50 cases which were diagnosed definitely by dynamic electrocardiogram.Results：R-R long intermittent account for 2.8% in this group, older than 60 years patients（86%） occupied the priority position, the mainly causes founded in atrial premature beats did not download（32%）,sinus arrest（24%）, and other causes rarely occured in the second and highly atrioventricular block, paroxysmal of speed,and the AF,premature ventrlcular after compensation, etc.Results：28 cases of R-R long intervals disappeared through medicine conservative treatment,9 cases symptomatic remission significantly;4 cases were implanted pacemaker;,4 eases refused pacemaker implanted operation just receied medicine conservative treatment which symptom improvement not strikingly.5 cases followed up unknown. Conclusion：Holter can discover and analyze the reasons which result in R-R long intermlttent,meanwhile provide an impercial basis on pacemaker implantion,lead a great guideline of clinical diagnosis and treatment.

关 键 词：动态心电图 R-R长间歇窦性停搏心脏起搏器 

分 类 号：R972.3[医药卫生—药品]