慢性心力衰竭CRT治疗中不同部位左心室起搏的效果比较

Effects Comparation of Different Parts of Left Ventricular Pacing in CRT Therapy of Chronic Heart Failure

目的比较慢性心力衰竭CRT治疗中不同部位左心室起搏的效果。方法随机选取2013年3月—2016年3月该院收治的慢性心力衰竭患者80例,依据左心室起搏部位将这些患者分为两组,即靠近间隔部组(n=40)和游离壁组(n=40),对两组患者的术中起搏参数、手术前后的心脏超声变化情况、术后半年的CRT临床应答和并发症发生情况进行统计分析。结果靠近间隔部组患者手术后的LVEF(0.4±0.1)%显著高于手术前(0.3±0.1)%(P<0.05),游离壁组患者手术后的LVEF(0.4±0.1)%显著高于手术前(0.3±0.1)%(P<0.05),LAD、LVESV(46.4±7.6)mm、(124.7±65.3)mm均显著低于手术前(50.5±8.9)mm、(143.4±67.4)mm,差异有统计学意义(P<0.05)。结论慢性心力衰竭CRT治疗中左心室电极位于游离壁比靠近间隔部具有较好的效果。

Objective To compare the effects of different parts of left ventricular pacing in CRT therapy of chronic heart failure. Methods 80 cases of patients with chronic heart failure in our hospital from March 2013 to March 2016 were randomly selected, these patients were divided into two groups in accordance with left ventricular pacing site,namely close spacing portion group（n = 40） and free wall of the group（n = 40）, the intraoperative pacing parameters,ultrasound changes before and after cardiac surgery, CRT response and clinical complications after six months of the two groups were analyzed statistically. Results The LVEF of the close spacing portion group after surgery（0.4±0.1）%was significantly higher than before surgery（0.3±0.1）%（P〈0.05）, the LVEF of the free wall of the group after surgery（0.4±0.1）% was significantly higher than before surgery（0.3±0.1）%（P〈0.05）, LAD, LVESV（46.4±7.6）mm,（124.7±65.3）mm were significantly lower than before surgery（50.5±8.9）mm,（143.4±67.4）mm（P〈0.05）. Conclusion The left ventricular free wall electrodes are located closer in CRT therapy of chronic heart failure has better effect than the spacing unit.