希氏束起搏与普通起搏术中患者射线暴露的比较  

Comparison of fluoroscopy exposure between HIS bundle pacing and conventional pacing during procedures

作　　者：刘晓宇[1] 张常莹[1] 郑杰[1] 郁志明[1] 王如兴[1] Liu Xiaoyu;Zhang Changying;Zheng Jie;Yu Zhiming;Wang Ruxing(Department of Candiology,Wuxi People′s Hospital,214023,China)

机构地区：[1]无锡市人民医院心血管内科,214023

出　　处：《中华放射医学与防护杂志》2020年第11期877-881,共5页Chinese Journal of Radiological Medicine and Protection

摘　　要：目的比较希氏束起搏(HBS)和右心室心尖起搏射线暴露的差异。方法回顾性记录无锡市人民医院2018年8月至2020年1月并分析30例希氏束起搏患者(HIS组)的手术总体及各阶段皮肤表面累积入射剂量(CD)和透视时间,并与同期右心室心尖植入心室电极的双腔起搏器(RVA)的32例患者(RVA组)对比。结果HIS组和RVA组的手术操作时间为(76.8±13.1)和(66.0±10.8)min(t=3.386,P<0.001)、透视时间为(698.2±113.7)和(293.3±63.9)s(t=14.709,P<0.001)、透视剂量为(391.3±70.0)和(162.3±40.5)mGy(t=13.694,P<0.001);与右心室心尖电极植入过程相比,希氏束电极植入过程的透视时间[(501.2±112.3)和(103.4±30.6)s]及透视剂量[(279.9±65.0)和(57.3±13.8)mGy]明显增加(t=15.864,Z=-6.524,P<0.001)。结论与右心室心尖起搏术相比,希氏束起搏手术时间更长,辐射剂量更大,需谨慎选择。Objective To compare the differences of fluoroscopy time and dose between HIS bundle pacing and right ventricle apex pacing.Methods This study includes thirty patients undergoing HIS bundle pacing(HIS group)and 32 patients undergoing right ventricular apex pacing(RVA group).The fluoroscopy time and cumulative dose(CD)to patients during surgery were recorded and analyzed.Results The operation time for patients in HIS group and RVA group were(76.8±13.1)and(66.0±10.8)min(t=3.386,P<0.001),respectively.The fluoroscopy time was(698.2±113.7)and(293.3±63.9)s(t=14.709,P<0.001)and the CD were(391.3±70.0)and(162.3±40.5)mGy(t=13.694,P<0.001)in HBP group and RVA group,respectively.In comparison,the fluoroscopy time and CD for HIS bundle electrode implantation were(501.2±112.3)s and(279.9±65.0)mGy,respectively,significantly higher than in the case of RVA,where the values were(103.4±30.6)s and(57.3±13.8)mGy(t=15.864,Z=-6.524,P<0.001).Conclusions Compared with right ventricular apical pacing,the HIS bundle pacing takes longer operation time,leading to higher radiation dose,which should be prudently selected.

关 键 词：希氏束 起搏 心血管介入 剂量 患者 

分 类 号：R541.7[医药卫生—心血管疾病]