起搏器术后患者常规及动态心电图监测的临床研究(1)
摘 要：目的 比较常规心电图与动态心电图在起搏器术后监测的效率，探讨分析动态心电图对不同起搏器术后监测的临床价值。方法 选取皖南医学院弋矶山医院心内科2016年5月～2017年12月100例起搏器植入术后患者为研究对象，所有患者均行常规心电图、动态心电图检测，比较常规心电图和动态心电图对起搏器术后功能异常检测效率，并分析动态心电图对不同起搏器感知、起搏功能异常以及起搏相关心律失常情况。结果 对起搏器植入术后患者动态心电图检测搏器功能异常为44例，高于常规心电图检测的16例，差异具有统计学意义(P<0.05)。DCG对不同类型起搏器感知和起搏功能异常、自身心律失常比较，差异无统计学意义(P>0.05)。结论 动态心电图对起搏器起搏功能异常的检测效能较12导心电图高，并且可以作为一种无创手段较好的了解不同类型起搏器工作状态，检测起搏功能异常和心律失常情况。
关键词：起搏器；动态心电图；常规心电图
中图分类号：R654.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.051
, 百拇医药
文章编号：1006-1959(2018)20-0163-03
Abstract：Objective To compare the efficiency of conventional electrocardiogram and dynamic electrocardiogram monitoring after pacemaker，and to analyze the clinical value of dynamic electrocardiogram for postoperative monitoring of different pacemakers. Methods A total of 100 patients with pacemaker implantation were enrolled in the Department of Cardiology，Yanjishan Hospital， Wannan Medical College.From May 2016 to December 2017，all patients underwent routine electrocardiogram and dynamic electrocardiogram detection.The efficiency of routine electrocardiogram and dynamic electrocardiogram for postoperative dysfunction of pacemaker were compared.The dynamic electrocardiogram was used to detect different pacemakers，pacing dysfunction and pacing-related arrhythmia.Results There were 44 cases of dynamic electrocardiographic abnormalities in pacemakers after pacemaker implantation，which was higher than 16 cases of conventional electrocardiogram，the difference was statistically significant(P<0.05). There was no significant difference in DCG between different types of pacemaker perception and pacing function and self-arrhythmia (P>0.05).Conclusion The dynamic electrocardiogram is more effective than the 12-lead ECG in the detection of pacemaker pacing dysfunction.It can be used as a non-invasive method to better understand the working status of different types of pacemakers，and to detect abnormal pacing and arrhythmia.
, 百拇医药
Key words：Pacemaker；Dynamic electrocardiogram；Conventional electrocardiogram
心脏起搏器(cardiacpacemaker)作为一种植入体内的电子治疗仪器，通过脉冲发生器发放、电池提供能量的电脉冲刺激心肌，使心脏激动和收缩而达到治疗某些心律失常所致的心脏功能障碍。近年来，随着心脏疾病的增加，心臟起搏器植入术也得到广泛使用[1]，其在心脏传导阻滞、顽固性心律失常、病态窦房结综合征等疾病中已得到临床认可。但起搏器植入术后也存在一定的并发症，如起搏器植入后感知功能异常和起搏功能失常等[2]，这些并发症的出现必然会降低临床疗效，如何准确、及时发现起搏器功能异常就显得尤为重要[3]。目前有临床实验发现，24 h动态心电图可连续不间断检测、捕捉心律失常，能发现常规12导心电图难以发现的非持续性心律失常[4]。本研究观察24 h动态心电图与常规12导心电图的效果比较并重点分析24 h动态心电图对不同类型起搏器临床应用价值。
1资料与方法
1.1一般资料 选取皖南医学院弋矶山医院心内科2016年5月～2017年12月100例起搏器植入术后患者为研究对象，所有患者均行常规心电图、动态心电图检测。其中男性58例，女性42例，年龄35～72岁，平均年龄(62.54±5.82)岁，病程为1～4年，平均病程为(2.58±1.50)年。术后随访1周～6年，起搏器使用者为：病态窦房结20例、Ⅱ度Ⅱ型房室传导阻滞35例、Ⅲ度房室传导阻滞34例、房颤伴心脏停搏11例，起搏器类型：VVI 22例、DDD 34例、VVIR 8例、DDDR 36例。, 百拇医药(王晓彤)
关键词：起搏器；动态心电图；常规心电图
中图分类号：R654.2 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.20.051
, 百拇医药
文章编号：1006-1959(2018)20-0163-03
Abstract：Objective To compare the efficiency of conventional electrocardiogram and dynamic electrocardiogram monitoring after pacemaker，and to analyze the clinical value of dynamic electrocardiogram for postoperative monitoring of different pacemakers. Methods A total of 100 patients with pacemaker implantation were enrolled in the Department of Cardiology，Yanjishan Hospital， Wannan Medical College.From May 2016 to December 2017，all patients underwent routine electrocardiogram and dynamic electrocardiogram detection.The efficiency of routine electrocardiogram and dynamic electrocardiogram for postoperative dysfunction of pacemaker were compared.The dynamic electrocardiogram was used to detect different pacemakers，pacing dysfunction and pacing-related arrhythmia.Results There were 44 cases of dynamic electrocardiographic abnormalities in pacemakers after pacemaker implantation，which was higher than 16 cases of conventional electrocardiogram，the difference was statistically significant(P<0.05). There was no significant difference in DCG between different types of pacemaker perception and pacing function and self-arrhythmia (P>0.05).Conclusion The dynamic electrocardiogram is more effective than the 12-lead ECG in the detection of pacemaker pacing dysfunction.It can be used as a non-invasive method to better understand the working status of different types of pacemakers，and to detect abnormal pacing and arrhythmia.
, 百拇医药
Key words：Pacemaker；Dynamic electrocardiogram；Conventional electrocardiogram
心脏起搏器(cardiacpacemaker)作为一种植入体内的电子治疗仪器，通过脉冲发生器发放、电池提供能量的电脉冲刺激心肌，使心脏激动和收缩而达到治疗某些心律失常所致的心脏功能障碍。近年来，随着心脏疾病的增加，心臟起搏器植入术也得到广泛使用[1]，其在心脏传导阻滞、顽固性心律失常、病态窦房结综合征等疾病中已得到临床认可。但起搏器植入术后也存在一定的并发症，如起搏器植入后感知功能异常和起搏功能失常等[2]，这些并发症的出现必然会降低临床疗效，如何准确、及时发现起搏器功能异常就显得尤为重要[3]。目前有临床实验发现，24 h动态心电图可连续不间断检测、捕捉心律失常，能发现常规12导心电图难以发现的非持续性心律失常[4]。本研究观察24 h动态心电图与常规12导心电图的效果比较并重点分析24 h动态心电图对不同类型起搏器临床应用价值。
1资料与方法
1.1一般资料 选取皖南医学院弋矶山医院心内科2016年5月～2017年12月100例起搏器植入术后患者为研究对象，所有患者均行常规心电图、动态心电图检测。其中男性58例，女性42例，年龄35～72岁，平均年龄(62.54±5.82)岁，病程为1～4年，平均病程为(2.58±1.50)年。术后随访1周～6年，起搏器使用者为：病态窦房结20例、Ⅱ度Ⅱ型房室传导阻滞35例、Ⅲ度房室传导阻滞34例、房颤伴心脏停搏11例，起搏器类型：VVI 22例、DDD 34例、VVIR 8例、DDDR 36例。, 百拇医药(王晓彤)