成人心脏外科术后心室电风暴处理与分析

发布时间：2018-08-07 11:03

【摘要】：目的:总结成人心脏外科术后心室电风暴(VES)的原因及治疗经验。方法:回顾性分析泰达国际心血管病医院2011-08至2015-05成人心脏术后发生VES患者36例,收集患者围手术期及发生VES前后的临床资料进行分析。结果:36例患者均在心脏术后重症监护病房发生VES(单纯冠状动脉旁路移植术23例,冠状动脉旁路移植术+室壁瘤切除5例,瓣膜置换术5例,Bentall术2例,Marrow术1例),32例(88.89%)VES消失后脱离呼吸机并顺利出院,4例(11.11%)死于多器官衰竭。心肌缺血所致VES22例(61.11%)。32例患者随访1年,28例(77.78%)恢复窦性心律,2例(5.56%)安置心内膜永久起搏器,2例(5.56%)出现心房颤动,随访期间未发生心因性死亡病例。结论:成人心脏外科术后VES多发生于术后早期,均能找到明确病因及诱因,及时发现并迅速组建高效合作团队采取有效措施,可以获得满意的效果。
[Abstract]:Objective: to summarize the causes and treatment experience of ventricular electrostorm (VES) after cardiac surgery in adults. Methods: 36 adult patients with VES after cardiac surgery from 2011-08 to 2015-05 in Teda International Cardiovascular Disease Hospital were retrospectively analyzed. The clinical data of the patients during perioperative period and before and after VES were analyzed. Results all 36 patients underwent VES (23 cases of coronary artery bypass grafting, 5 cases of ventricular aneurysm resection) in the intensive care unit after cardiac surgery (23 cases of coronary artery bypass grafting and 5 cases of coronary artery bypass grafting). Valvular replacement was performed in 2 cases (1 case). 32 cases (88.89%) died of multiple organ failure after VES disappeared and 4 cases (11.11%) died of multiple organ failure. There were 28 cases (77.78%) with sinus arrhythmia and 2 cases (5.56%) with endocardial permanent pacemaker implantation. Atrial fibrillation was found in 2 cases (5.56%). Conclusion: adult cardiac surgery VES mostly occurs in the early stage of operation, which can find out the cause and cause, and find out and quickly set up an efficient cooperative team to take effective measures, which can obtain satisfactory results.
【作者单位】：泰达国际心血管病医院心脏外科术后监护室;泰达国际心血管病医院心外科;中国医科大学第一附属医院心脏外科;
【分类号】：R654.2

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