临时起搏器在腹部手术中的应用分析

The an alysis of temporary pacemaker in abdominal surgery

目的探讨临时起搏器在腹部手术中合并有心脏起搏及传导系统障碍患者中应用的必要性。方法对42例合并缓慢型心律失常的外科患者在术前植入心脏临时起搏器,术中和术后行心电图监测记录,观察起搏器的工作状态。结果 42例中起搏器起搏有64%,其中严重窦性心动过缓、Ⅱ度房室传导阻滞(AVB)、心房纤颤伴长间歇(>2 s)和双束支阻滞的患者临时起搏器工作状态多,患者合并心肌梗死、瓣膜病和心肌病时,是术中发生严重缓慢性心律失常的高危人群,具有临时起搏器植入的明显指征。结论在腹部手术中合并有缓慢型心律失常、Ⅱ度AVB、心房纤颤伴R-R长间歇和双束支阻滞者在行外科手术前,植入心脏临时起搏器可以为手术的顺利进行提供安全保障。

Objective To study the necessity of temporary pacemaker in abdominal surgery combined with cardiac pacemaker and conduction system obstacles. Methods Preoperatively, the temporary pacemakers were implanted in 42 cases of surgical patients combined the slow type of cardiac arrhythmias. Electrocardiogram （ECG） were monitored continuously during and after operation, observe the working state of the pacemaker. Results The temporary pacemaker in the patients who had serious sinus bradycardia, second degree atrioventricular block, atrial fibrillation wire long intervals （〉2 s） or double bundle branch block were most in a working state. Patients with myocardial infarction, valvular disease and cardiomyopathy were the high-risk groups of brady arrhythmia, who had the indication of temporary pacemaker implantation. Conclusion Before the abdominal surgery, with slow arrhythmia, Ⅱ degrees AVB, fibrillation atrial with R-R long intervals and double bundle branch block line before surgery, temporary pacemakers can be implanted in the heart to provide security for the operation.