介入治疗先天性心脏病患儿对其心律失常与心率变异性及术后心功能指标的影响

Effect of interventional therapy on arrhythmia and heart rate variability and postoperative cardiac function in children with congenital heart disease

目的探讨介入治疗先天性心脏病患儿对其心律失常、心率变异性及术后心功能指标的影响。方法选取2018年1月至2020年12月赣南医学院第一附属医院及兴宁市人民医院收治的54例先天性心脏病患儿作为研究对象,所以患儿均进行介入治疗。比较治疗前后心律失常检出率、心功能指标(左心射血分数、肺动脉压力、左房大小)、心率变异性指标[窦性心搏间标准差(SDNN)、相邻正常心动周期差值的均方根(rMSSD)、5 min正常心动周期标准差的平均数(ASDNN)、5 min正常心动周期平均值的标准差(SDANN)、相邻正常心动周期之差>50 ms的个数占整个窦性心搏个数的百分比(PNN50)]及生命质量评分。结果治疗后,心律失常检出率为70.37%,高于治疗前的48.15%,差异有统计学意义(P<0.05)。治疗后,左心射血分数大于治疗前,肺动脉压力低于治疗前,左房大小小于治疗前,差异有统计学意义(P<0.05)。治疗前后rMSSD、ASDNN、PNN50比较差异无统计学意义;治疗后,SDNN、SDANN均小于治疗前,差异有统计学意义(P<0.05)。治疗后,身体感受、焦虑相关治疗、认知、交流、疾病相关问题评分均高于治疗前,差异有统计学意义(P<0.05)。结论介入治疗先天性心脏病患儿会导致心律失常发生率升高,但可有效改善患儿心功能、心率变异性指标,提高患儿生命质量,值得临床推广应用。

Objective To investigate the effects of interventional therapy on arrhythmia,heart rate variability and cardiac function in children with congenital heart disease.Methods 54 children with congenital heart disease admitted to the First Affiliated Hospital of Gannan Medical College and Xingning People's Hospital from January 2018 to December 2020 were selected as the study subjects,all the children received interventional treatment.The arrhythmia detection rate,cardiac function index(left heart ejection fraction,pulmonary arterial pressure,left atrial size),heart rate variability index(standard deviation of normal RR intervals[SDNN],root mean square of successive differences[rMSSD],average of all 5 minute standard deviations[ASDNN],standard deviation of per-5 min averages normalnumber ofintervals[SDANN],percent of NN 50 in the total number of RR intervals[PNN50])and the quality of life score were compared before and after treatment.Results After treatment,The detection rate of arrhythmia was 70.37%,which was higher than 48.15%before treatment,and the difference was statistically significant(P<0.05).After treatment,left ventricular ejection fraction was higher than before treatment,pulmonary artery pressure was lower than before treatment,and left atrial size was smaller than before treatment,the differences were statistically significant(P<0.05).There were no significant differences of rMSSD,ASDNN and PNN50 before and after treatment;after treatment,SDNN and SDANN were lower than those before treatment,and the differencse were statistically significant(P<0.05).After treatment,the scores of body sensation,anxiety-related treatment,cognition,communication and disease-related problems were higher than those before treatment,and the differences were statistically significant(P<0.05).Conclusion Interventional treatment of children with congenital heart disease can lead to increased incidence of arrhythmia,but it can effectively improve the cardiac function and heart rate variability of children and improve the quality of life of children,which is worthy of clinical promotion and application.