心脏永久性起搏器的不同起搏部位对植入患者心功能的影响

The Effect of Different Pacing Sites of Permanent Cardiac Pacemaker on the Cardiac Function of Implanted Patients

目的:分析心脏永久性起搏器的起搏部位对植入患者心功能所产生的影响。方法:选择2019年2月~2020年1月到本院心血管内科进行永久性心脏起搏器植入术治疗的120例患者,根据心脏起搏器植入部位不同分为一组和二组,一组植入部位为心脏右室心尖部,共52例,二组选择希氏束起搏(希浦系统起搏),共68例,对所有患者心脏起搏器植入前和植入后6个月的左室射血分数、左房射血分数、血浆脑钠肽等指标进行比较,统计两组研究对象不良事件的发生率。结果:①本文两组患者6个月之内均没有出现死亡病例,不良事件发生率之间无差异(P>0.05);②两组患者植入起搏器前心功能指标之间没有明显差异(P>0.05),植入起搏器后差异明显(P<0.05);③二组患者的满意度明显比一组患者更高,差异有统计学意义(P<0.05);④二组患者术后的凝血功能改善优于一组,差异有统计学意义(P<0.05);⑤二组患者术后的生活质量明显比一组患者更高,差异有统计学意义(P<0.05)。结论:希氏束起搏相对于右室心尖部植入更有助于促进患者的左房和左室射血功能的改善,不会对心脏功能产生较大影响,可更好改善患者的凝血功能,提升生活质量和满意度,建议选为首选起搏点考虑。

Objective:To analyze the impact of the pacemaker of a permanent cardiac pacemaker on the cardiac function of implanted patients.Methods:120 patients who underwent permanent pacemaker implantation in the Department of Cardiology of our hospital from February 2019 to January 2020 were divided into the first group and the second group according to the different implantation sites of pacemakers.A total of 52 cases were implanted at the apex of the right ventricle of the heart in the first group,and 68 cases were selected in the second group.The left ventricular ejection fraction,left atrial ejection fraction,plasma brain natriuretic peptide and other indexes of all patients before and 6 months after pacemaker implantation were compared,and the incidence of adverse events in the two groups was counted.Results:①There were no deaths within 6 months in the two groups of patients,and there was no difference in the incidence of adverse events(P>0.05);②There was no significant difference in cardiac function between the two groups before the implantation of the pacemaker(P>0.05),and the difference was significant after the implantation of the pacemaker(P<0.05);③The satisfaction of the patients in the second group was significantly higher than that of the patients in the first group,and the difference was statistically significant(P<0.05);④The improvement of the coagulation function of the patients in the second group was better than that in the first group,and the difference was statistically significant(P<0.05);⑤The postoperative quality of life of patients in the second group was significantly higher than that in the first group,and the difference was statistically significant(P<0.05).Conclusion:Compared with the right ventricular apex implantation,the patients should be His bundle pacing is more helpful to improve the left atrial and left ventricular ejection function of the patient,and will not have a major impact on the cardiac function,and can better improve the patient It is recommended to choose the preferred pacing point to consider because of its blood coagulation function and improve the quality of life and satisfaction.