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目的探讨经导管封堵室间隔缺损(VSD)术迟发性完全性房室传导阻滞(CAVB)的防治措施。方法对2例VSD封堵术后发生迟发性CAVB患者的临床表现、心电图特点及药物治疗反应进行回顾性分析。结果2例VSD患者分别于经导管封堵术后第4天及第6天突发晕厥,心电图及动态心电图均证实为间歇性CAVB,经用大剂量激素治疗后症状消失,心电图及动态心电图恢复正常。结论(1)VSD经导管封堵术后有可能发生迟发性CAVB,应适当延长心电监护及住院时间;(2)对VSD封堵术后发生的迟发性CAVB可用大剂量激素进行治疗。
Objective To investigate the prevention and treatment of late complete atrioventricular block (CAVB) by transcatheter closure of ventricular septal defect (VSD). Methods The clinical manifestations, electrocardiogram (ECG) characteristics and medication response of two patients with delayed-onset CAVB after occlusion of VSD were retrospectively analyzed. Results Two patients with VSD developed sudden syncope on the 4th and 6th days respectively after catheter closure. The electrocardiogram and the dynamic electrocardiogram were all confirmed as intermittent CAVB. The symptoms disappeared after the treatment with high-dose hormone. The electrocardiogram and electrocardiogram were recovered normal. Conclusions (1) Delayed CAVB may occur in patients with VSD after transcatheter closure, and ECG monitoring and hospitalization should be prolonged properly. (2) Delayed CAVB can be treated with high-dose hormone after VSD closure .