论文部分内容阅读
目的探讨应用食管调搏筛选无症状窦性心动过缓的非心脏手术患者,评价对此类患者植入临时起搏器是否可减少围术期严重心血管事件及并发症的发生风险。方法选择2009至2011年间住院行非心脏手术、未服用β受体阻滞剂及其他减慢心室率药物的无症状窦性心动过缓患者,术前心电图无束支阻滞,24小时动态心电图、阿托品试验阳性提示可疑窦房结功能障碍,排除有植入永久心脏起搏器指征患者共156例。将患者分为3组:一般年龄组(<59,n=73)、老年组(60~74,n=54)及高龄组(>75,n=29)。术前行食管调搏评价窦房结功能。于术前经中心静脉植入临时起搏器,观察并记录围术期起搏器的工作情况等。结果①全部患者于术前床旁植入临时心脏起搏器;②食管调搏阳性共32例,高龄组食管调搏阳性率较高;③食管调搏阳性患者起搏比例较高。结论食管调搏评估无症状性窦性心动过缓患者窦房结功能,高龄组窦房结功能不全阳性率较高;食管调搏阳性患者术中出现严重心动过缓风险明显增加;食管调搏阳性患者术前植入临时心脏起搏器可有效治疗围术期严重心动过缓,改善预后。
Objective To investigate the application of esophageal pacing in the screening of asymptomatic sinus bradycardia in non-cardiac surgery patients to assess whether such patients can be implanted temporary pacemaker can reduce the perioperative cardiovascular events and complications of the risk. Methods From 2009 to 2011, hospitalized patients undergoing noncardiac surgery, without taking β-blockers and other asymptomatic sinus bradycardia slowed down ventricular rate drugs, preoperative ECG without bundle branch block, 24-hour ambulatory electrocardiogram , Atropine test positive suspicious sinus node dysfunction, excluding implanted permanent cardiac pacemaker indications of a total of 156 patients. The patients were divided into 3 groups: the general age group (<59, n = 73), the elderly group (60-74, n = 54) and the elderly group (> 75, n = 29). Preoperative esophageal pacing assessment of sinus node function. In the preoperative central venous implanted temporary pacemaker, observe and record the perioperative pacemaker work. Results ① All the patients were implanted with temporary cardiac pacemaker at the bedside of surgery. ② A total of 32 esophageal squashes were positive, and the positive rate of esophageal calculus was higher in elderly patients. ③ The proportion of esophageal pacing positive patients was higher. Conclusion Esophageal pacing assessment of sinus node function in patients with asymptomatic sinus bradycardia, high incidence of sinus node dysfunction in the higher positive rate; esophageal pacing-positive patients were significantly increased risk of severe bradycardia; esophageal pacing Preoperative implantation of temporary cardiac pacemaker positive patients can effectively treat perioperative bradycardia and improve prognosis.