冠状动脉内导丝起搏在急性下壁心肌梗死合并高度房室传导阻滞患者中应用价值分析

The application of incoronary wire pacing in acute inferior wall myocardial infarction patients associated with complete atrioventricular block

目的探讨冠状动脉内导丝起搏(ICP)在急性下壁心肌梗死合并高度房室传导阻滞患者中的应用价值。方法选取自2020年1月至2021年1月辽阳市中心医院收治的64例急性下壁心肌梗死合并高度房室传导阻滞患者为研究对象。所有患者均成功实施经皮冠状动脉介入术(PCI)。按照术中心律失常的治疗方法将患者分为临时起搏器(TPM)组(n=30)与ICP组(n=34)。记录两组患者X线曝光时间、曝光量、造影剂用量,靶血管情况,起搏情况,手术时间,住院时间,入院到球囊开通(D2B)时间,以及院内并发症发生情况。结果两组患者冠状动脉靶血管、造影剂用量、X线曝光时间、X线曝光剂量、住院时间比较,差异无统计学意义(P>0.05)。ICP组心室起搏比例低于TPM组,心房起搏比例高于TPM组,差异有统计学意义(P<0.05)。ICP组D2B时间、手术时间短于TPM组,差异有统计学意义(P<0.05)。ICP组术区血肿发生率明显低于TPM组,差异有统计学意义(P<0.05)。结论急性下壁心肌梗死合并高度房室传导阻滞患者术中应用ICP可有效起搏心肌,且有效缩短D2B时间及手术时间。

Objective To investigate the application value of intra coronary guide wire pacing(ICP)in patients with acute inferior wall myocardial infarction complicated with high atrioventricular block.Methods A total of sixty-four patients with acute inferior wall myocardial infarction complicated with high atrioventricular block admitted to the Central Hospital of Liaoyang from January 2020 to January 2021 were selected as the research subjects.All patients underwent percutaneous coronary intervention(PCI).Patients were divided into temporary pacemaker(TPM)group(n=30)and ICP group(n=34)according to the treatment of intraoperative arrhythmia.X-ray exposure time,exposure amount,amount of contrast agent,target vascular condition,pacemaker condition,operation time,hospital stay time,door to balloon time(D2B),and incidence of hospital complications were recorded in each group.Results There was no significant difference between the two groups in the amount of coronary artery target angiography agent,X-ray exposure time,exposure dose and length of hospital stay(P>0.05).The proportion of ventricular pacing in ICP group was lower than that in TPM group,and the proportion of atrial pacing was higher than that in TPM group,with statistical significance(P<0.05).The D2B time and operation time in ICP group were shorter than those in TPM group,and the differences were statistically significant(P<0.05).The incidence of hematoma in ICP group was significantly lower than that in TPM group,the difference was statistically significant(P<0.05).Conclusion Incoronary wire could successfully pace the myocardium,besides,it could shorten the time of D2B,operation time.