71例心脏术后心室电风暴的原因分析及治疗体会

Analysis of Cause and Treatment for Ventricular Electrical Storm After Cardiac Surgery in 71 Patients

目的:分析总结我院71例心脏术后心室电风暴的原因及治疗体会。方法:回顾性分析我院2010-01至2013-07期间71例心脏术后心室电风暴患者的资料。统计患者一般情况,手术方式、术中情况及术后血流动力学资料。结果:71例(51例为冠状动脉旁路移植术后,14例为瓣膜置换术后,3例先天性心脏病均为室间隔缺损修补术后,其中1例为左心室流出道疏通术后,1例为胸外科Mini-Maze术后,1例为Bentall术后)患者均为心脏术后发生心室电风暴。71例患者发生心室电风暴均能找到原因并定位室性心律失常起源位置,去除病因,心电监测下电复律、起搏器超速抑制,静脉推注抗心律失常药物,5例患者死亡,66例患者心室电风暴均全部纠治。结论:心脏术后心室电风暴临床上应结合不同的情况迅速处理,以提高抢救成功率。

Objective： To analyze the cause and treatment of ventricular electrical storm in patients after cardiac surgery. Methods： A total of 71 patients with post-operative ventricular electrical storm in our hospital from 2010-01 to 2013-07 were retrospectively analyzed. The basic clinical information, surgical manner, in-operative condition and post-operative hemodynamics were summarized in all patients. Results： There were 51 patients after coronary artery bypass grafting, 14 after valvular displacement, 3 after the surgical repair of ventricular septal defect, 1 after post-operative left ventricular outlfow tract clear, 1 after post-operative thoracic mini-maze treatment and 1 after post-operative Bentall treatment. The causes of ventricular storm were fond and the origins of ventricular arrhythmia were located in all 71 patients. Different patients were speciifcally treated for different causes by electrical cardio-version with ECG monitoring, pacemaker overdrive suppression and intravenous injection of anti-arrhythmic medication. There were 66 patients cured and 5 died. Conclusion： The patients with post-operative ventricular electrical storm should be treated immediately to improve the success rate of rescue.