体外循环先天性心脏病纠治术对心率变异性的影响

Effects of Congenital Heart Diseases Undergoing Extracorporeal Circulation about Heart Rate Variability

目的 探讨体外循环心内直视手术创伤对心脏自主神经系统的影响。方法 观察 30例先天性心脏病房、室间隔缺损患者行心内修补术术前、术中及术后 7d的心率变异性变化。结果 术中及术后 4d内低频 (L F)、高频 (HF)和总频 (TP)较术前明显下降 (P<0 .0 5 ) ,术中体外循环结束时达最低值 (P<0 .0 1) ,术后第 7天恢复接近至术前水平 ,总体表现为一个缓慢上升的趋势。结论 心脏手术、体外循环、低温、主动脉阻断及药物因素可导致心率变异性下降 。

Objective To analyse the effect of autonomic cardioneural system in patients with heart diseases undergoing extracorporeal circulation.Methods The changes of heart rate variability(HRV) were recorded before,during and after operation for 7 days in 30 patients with congenital heart diseases.Results Low frequency (LF),high frequency HF) and total power (TP)were obviously decreasing during operation and after operation in 4 days (P<0.05) to come to the lowest peak after extracorporeal circulation (P<0.01).There was a slow rising of tendency after operation and the value were close to the preoperative lever at 7th day.Conclusion The hypothermia,extracorporeal circulation,clamp of aorta and drugs,etc.can lead to decrease of HRV in cardiac surgery.The resume of autonomic cardioneural system was a slow process.