临时人工心脏起搏在先天性心脏病术中及术后的应用

Temporary clinical application of cardiac pacing during and after open-heart surgery for congenital heart disease

目的 探讨临时人工心脏起搏治疗在先天性心脏病术中及术后应用的临床意义。方法 对 1999年 3月～ 2 0 0 2年 12月 15例因术中或术后出现各种心律失常 (主要为缓慢型心律失常 )的先天性心脏病患儿行临时人工心脏起搏治疗。术中及术后床旁紧急开胸右心室心外膜放置临时人工心脏起搏 ,全部以VVI型起搏方式 ,并配和药物治疗。结果 15例患儿均于术后 1～ 14d转为稳定窦性心律 ,出院前全部拆除起搏导线 ,并康复出院未留置永久性心内膜起搏器。结论 先天性心脏病术中及术后出现各种心律失常 ,术中与手术操作有关 ,正确认识房室传导组织的解剖是防止损伤的关键。术后宜尽早放置临时起搏器 ,帮助患儿恢复自主心律 。

Objective To explore the experience on temporary cardiac pacing during and after open-heart surgery for congenital heart disease(CHD). Methods Fifteen patients with CHD and arrythmia perioperatively between March 1999 to December 2002 were treated by temporary cardiac pacing. Temporary epicardiac pacing included during and after operation,VVI model pacemakers were used and all patients were treated assistedly by adding some antiarrythmia drugs. Results It covered 1～14 days after open-heart surgery for patients to resume normal sinus rhythm.All the temporary cardiac pacing of remained patients had been disengaged before hospital discharge,all patients recovered normally and did not require permanent cardiac pacemakers.Conclusions To prevent injury,it is important to fully understand the surgical anatomy of atrioventricular conducting tissue.The temporary pacemaker should be implanted early to help the patients resume normal sinus rhythm and recover in the postoperation.