永久性人工心脏起搏器的临床应用效果及短期随访观察

The clinic effect of permanent artificial heart pacemaker and short-term follow-up

目的观察分析永久性人工心脏起搏器的临床应用效果和短期随访结果。方法选取2012年6月至2014年12月在该院植入永久性人工心脏起搏器的86例患者为研究对象,根据安置人工心脏起搏器类型分为双腔起搏器组(DDD型组)40例和单腔心室按需型起搏器组(VVI型组)46例,观察两组患者术后的临床效果并对患者进行短期跟踪调查。结果植入起搏器前后DDD型组患者头晕、胸闷、乏力、黑蒙、晕厥发生情况与VVI型组比较,差异均无统计学意义(P>0.05)。植入起搏器后两组患者左心室舒张末期容积指数(EDVI)、左心室收缩末期容积指数(ESVI)、左心室射血分数(LVEF)等均高于植入前,差异均有统计学意义(P<0.05);同时,DDD型组患者EDVI、ESVI、LVEF等均高于VVI型组,差异均有统计学意义(t=7.182、3.744、4.330,P<0.01);DDD型组植入后3个月并发症发生率[30.00%(12/40)]低于VVI型组[54.35%(25/46)],差异有统计学意义(χ2=5.174,P<0.05)。结论 2种类型的起搏器均可以改善患者症状,但DDD型在提高EDVI、ESVI、LVEF等方面优于VVI型,且并发症发生率低于VVI型。

Objective To observe and analyze the clinical effect of permanent artificial heart pacemaker and short-term follow-up results. Methods A total of 86 patients with permanent artificial heart pacemaker implantation in this hospital from June 2012 to December 2012 were chosen as the object in this study. According to the type of permanent artificial heart pacemak-er,the patients were divided into two groups：the dual chamber pacemaker group（the DDD group）,40 cases and the ventricular demand pacemaker group（the VVI group）,46 cases. The clinical effects after permanent artificial heart pacemaker implantation were observed and a short-term follow up survey was conducted. Results The clinical symptoms such as the chest stuffy,the asthenia,black hazy and faints of the two groups had no statistical significance（P〉0.05）. The indexes of EDVI,ESVI and LVEF after permanent artificial heart pacemaker implantation in the two groups were higher than those before the surgery with the differ-ence being statistically significant（P〈0.05）. Meanwhile,the status of EDVI,ESVI and LVEF in type DDD group was better than those of type VVI group,whose difference being statistically significant（t=7.182,3.744,4.330,P〈0.01）. The occurrence of complications of the DDD group[30.00%（12/40）] were lower than that of the VVI group [54.35%（25/46）]three months after permanent artificial heart pacemaker implantation and the difference was statistically significant（χ2=5.174,P〈0.05）. Conclusion Two types of pacemaker may improve the symptoms,but type DDD is superior than type VVI in raising EDVI,ESVI and LVEF,but lower than type VVI in incidence of complications.