心脏移植术后窦房结功能异常（附1例报道）

Sinus Node Dysunction after Heart Transplantation-One Case Report

心脏移植术后窦房结自律性及传导功能受损的发生率很高，临床表现为以心率缓慢为主的窦房结功能紊乱。我院于１９９２年收治一例。供心缺血时间２７１分钟，采用美国Ｓｔａｎｆｏｒｄ医疗中心基本术式，术后窦性、结性心律交替，出现窦房阻滞及窦暂停，于术后第１４周安装了永久性心内膜起搏器。心脏移植术后发生窦房结功能损害的原因是多方面的，可以是各种因素的综合影响，再通过窦房结供血障碍而加剧。术后早期可采用药物治疗或临时起搏技术，心动过缓持续３～４周以上者，应尽早考虑安装心内膜永久性起搏系统。

The incidence of the defected sinus node automaticity and sinoatrial conductivity after heart transplantation is rather high.Bradycardia was the usual clinical apearance of sinus nodedysfunction.one case of heart transplantation was performed in our hospital in l992.The donor heart ischemic time was 271 minutes.The basic operative procedure of Stanford Medical Center was followed.Alternation of sinus and nodal rhythm,sinoatrial block and transient sinus arrest revealed postoperatively.A permanent pacemaker was implanted at the fourteenth postoperative week.Various factors which can simultaneously impair the sinus node function were discussed. Medicine therapy and temporary pacing could be attempted during the early period after operation,but implantation of permanent endocardial pacing system should be suggested if bradycardia persists over 3 to 4 weeks.