心脏起搏技术在COPD合并缓慢型心律失常中的应用研究

发布时间：2018-03-04 11:34

本文选题：心脏起搏　切入点：人工　出处：《重庆医学》2017年15期 　论文类型：期刊论文

【摘要】：目的分析慢性阻塞性肺疾病(COPD)合并缓慢型心律失常接受起搏治疗的病因、疗效、安全性和方法学特点。方法选择该院265例接受心脏起搏治疗的患者,其中合并COPD的缓慢型心律失常患者125例(观察组),不合并COPD的缓慢型心律失常患者140例(对照组),比较两组病因、疗效、安全性及方法学。结果对照组与观察组中病态窦房结综合征为95例(68.57%)和68例(54.40%);观察组的房室传导阻滞患者[44例(31.5%)]明显高于对照组[57例(45.6%)],比较差异有统计学意义(P0.05)。起搏器植入术后2周,对照组中平均心率、最慢心率、左室收缩功能显著提高,左房、右房、左室舒张内径、右室舒张内径和右室收缩压显著缩小,与术前比较差异均有统计学意义(P0.05)。术后观察组中平均心率、最慢心率、右室舒张内径、左室收缩功能和右室收缩压等指标与术前比较差异有统计学意义(P0.05)。观察组手术时间长于对照组,静脉穿刺术、心房电极调整数、心室电极调整数与对照组相比均有增加(P0.05)。再入院率观察组较高,两组患者的病因分布比较差异有统计学意义(P0.05)。两组右室电极位置分布比较差异有统计学意义(P0.05)。结论 COPD合并缓慢型心律失常以病态窦房结综合征为主要类型,心脏起搏器植入对其治疗有效,右室心尖部是较优的起搏部位,相对于不合并COPD的患者,其手术难度较大。
[Abstract]:Objective to analyze the patients with chronic obstructive pulmonary disease (COPD) clinical etiology, combined with bradyarrhythmia received pacing therapy, the characteristics of safety and methods of 265 cases undergoing cardiac pacing therapy in patients with COPD, including 125 patients with slow arrhythmia patients (observation group), with 140 slow type arrhythmia in patients with COPD patients (control group), compared with two groups of curative effects, etiology, safety and methodology. The control group and the observation group in sick sinus syndrome was 95 cases (68.57%) and 68 cases (54.40%); observation of atrioventricular block patients with [44 group was significantly higher than that (31.5%)] the control group [57 (45.6% cases), the difference was statistically significant (P0.05). 2 weeks after the implantation of pacemaker, the average heart rate in the control group, the heart rate, left ventricular systolic function improved significantly, left atrium, right atrium, left ventricular diastolic diameter, right ventricular diastolic diameter and right ventricular systolic pressure was significantly reduced Small, compared with the preoperative differences were statistically significant (P0.05). After the operation in the observation group, the average heart rate, slow heart rate, right ventricular diastolic diameter, systolic function and right ventricular systolic pressure and left ventricular index operation before the difference was statistically significant (P0.05). The operation time of the observation group than in control group, intravenous puncture atrial electrode adjustment, ventricular electrode adjustment compared with the control group increased significantly (P0.05). The readmission rate of observation group was higher, there was significant difference between the etiology of two groups of patients (P0.05). The two groups had statistical significance of right ventricular electrode position distribution difference (P0.05). Conclusion COPD combined with slow type of arrhythmia in sick sinus syndrome is the main type of pacemaker implantation, effective treatment of the right ventricular apical pacing site is better, compared with patients with COPD, the operation is very difficult.

【作者单位】：云南省第一人民医院老年病科;
【分类号】：R541.7;R563.9

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