临时心脏起搏在胆道外科急症中的应用

APPLIED TEMPORARY CARDIAC PACING IN BILIARY TRACT SURGICAL EMERGENCY AND SLOW ARRHYTHMIA

目的观察患胆道外科急症伴冠心病/扩张型心肌病并缓慢型心律失常患者同时行心脏起搏治疗及外科手术的可行性及安全性。方法胆石症、胆道感染伴冠心病/扩张型心肌病并缓慢型心律失常患者28例,分为不安装起搏器组及对照组,观察组常规安装临时心脏起搏器并进行外科手术治疗,对照组给予异丙肾上腺素及阿托品,控制心率在60次/min左右进行外科手术。结果观察组安装临时心脏起搏器及胆囊切除、胆道引流手术均成功,症状缓解,胆道感染得到有效控制。对照组中11例胆道手术成功,症状缓解,2例术后症状加重(其中1例手术过程心率下降,症状加重)自动出院,3例因心率缓慢,未能手术,症状加重,自动出院。结论在胆石症、胆道感染伴冠心病/扩张型心肌病并缓慢型心律失常患者中,安装临时心脏起搏器同时进行外科手术是可行的,也是必要和安全的。

Objective To observe the safety and effect of temporary cardiac pacing and surgical operation in biliary tract surgical emergency and slow arrhythmia. Methods 28 patients with biliary tract inflammation and slow arrhythmia combined coronary heart disease or dilated cardiomyopathy were divided into tow groups, temporary cardiac pacing group, applied temporary cardiac pacing and surgical operation; control group, applied with Isoproterenol and surgical operation. Results Temporary cardiac pacing group, performed temporary cardiac pacing and cholecystectomy, choledochostomy with drainage , whose effect were perfect. The control group, 11 patients successfully performed choledochostomy, 5 patients were exacerbated and 3 patients performed no surgical operation. Conclusion The safety and effect of temporary cardiac pacing and surgical operation in patients with biliary tract inflammation and slow arrhythmia combined coronary heart disease or dilated cardlomypathy are reliable and applicable,