儿童室间隔缺损介入封堵术后心律失常及其危险因素分析

The analysis of cardiac arrhythmias and their risk factors were analyzed by the children's ventricular septal defect

目的:探讨室间隔缺损(VSD)介入堵闭术后心律失常及其危险因素,评价VSD介入堵闭术的安全性和疗效。方法:回顾分析2014年1月—2016年12月在重庆医科大学附属儿童医院心血管内科行VSD介入堵闭术患者的临床表现、心电图(ECG)及/或动态心电图、超声心动图(Transthoracic echocardiography,TTE)等术前检查、术中操作及心电监测,以及术后复查随访资料。结果:本研究381例行室间隔缺损介入堵闭术患者中,有367例堵闭成功,成功率为96.3%。术后有84例术后发生心律失常,占22.89%。包括传导阻滞58例、起源异常类26例,发生严重心律失常有3例。术前有无心律失常、是否合并膜部瘤、手术时间长短、室间隔缺损直径大小、堵闭器直径大小与介入术后心律失常的发生具有相关性。结论:心律失常是行VSD堵闭术后比较常见的一种并发症,我们应该在术前了解VSD的解剖形态、严格遵守手术适应症、依据VSD直径来选择适宜的封堵器、术中尽量缩短手术时间,以减少VSD介入堵闭术后心律失常的发生。

Objective： To investigate the arrhythmia and its risk factors ofventricular septal defect （VSD）, and evaluate its safety and efficacy. Methods： Analysis of the clinical data of patients with VSD intervention in our hospital from January 2014 to December 2016. Results： Of the 381 patients, 367 were successful and the success rate was 96.3%. There were 84 cases of cardiac arrhythmia, accounting for 22.89 percent. Conclusions： Line is the VSD wall close postoperative arrhythmia is a common complication, we should know before surgery VSD anatomical morphology, shorten operation time as far as possible, in order to reduce the occurrence of arrhythmia.