围术期应用临时心脏起搏器致恶性心律失常的原因分析及对策(1)
【摘要】 目的 研究圍术期应用临时心脏起搏器致恶性心律失常的原因。方法 90例围术期应用临时心脏起搏器患者， 将11例出现恶性心律失常的患者设为A组， 另79例未出现恶性心律失常的患者设为B组。分析并整理两组患者的临床资料， 统计围术期使用临时心脏起搏器致恶性心律失常的原因。结果 两组性别、手术类型、合并症比较， 差异无统计学意义(P>0.05);两组年龄、起搏器正常起搏、电极脱落、电极异常放电、术前左心室舒张末期内径(LVEDD)、术前左心室射血分数(LVEF)、术前汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、电池、接口松动或者脱落、参数合理、电极移位、使用电刀、手术位置、模式情况比较， 差异有统计学意义(χ2=4.060、4.729、5.174、9.131、3.925、4.780、8.577、6.512、10.340、6.221、8.054、10.957、6.038、8.577、7.557， P<0.05)。结论 围术期应用临时心脏起搏器可导致恶性心律失常， 若能够完全掌握心律失常产生的原因， 可尽早制定相关干预措施， 减少心律失常的发生， 为患者预后提供保障。
【关键词】 围术期;恶性心律失常;临时心脏起搏器;心脏功能
DOI：10.14163/j.cnki.11-5547/r.2020.30.003
Cause analysis and countermeasures of malignant arrhythmia caused by temporary cardiac pacemaker during perioperative period ZHONG Yu-ting， TIAN Ke-jun. Department of Anesthesia， First Affiliated Hospital of Gannan Medical College， Ganzhou 341000， China
【Abstract】 Objective To study the cause of malignant arrhythmia caused by temporary cardiac pacemaker during perioperative period. Methods Among 90 patients who were treated with temporary cardiac pacemaker during perioperative period， 11 patients with malignant arrhythmia were set as group A， and 79 patients without malignant arrhythmia were set as group B. The clinical data of the two groups were analyzed and sorted out， and the causes of malignant arrhythmia caused by temporary cardiac pacemaker during perioperative period were statistically analyzed. Results There was no statistically significant difference in gender， type of operations and complications between the two groups (P>0.05). There was statistically significant difference in age， normal pacemaker pacing， electrode shedding， abnormal electrode discharge， preoperative left ventricular end diastolic diameter (LVEDD)， preoperative left ventricular ejection fraction (LVEF)， preoperative Hamilton anxiety scale (HAMA) score， Hamilton depression scale (HAMD) score， battery， loose or disconnected interface， reasonable parameters， electrode shift， use of electrocautery， surgical position， mode situation between the two groups (χ2=4.060， 4.729， 5.174， 9.131， 3.925， 4.780， 8.577， 6.512， 10.340， 6.221， 8.054， 10.957， 6.038， 8.577， 7.557， P<0.05). Conclusion The use of temporary pacemakers during the perioperative period can cause malignant arrhythmia. If the cause of the arrhythmia can be fully grasped， relevant intervention measures can be formulated as soon as possible to reduce the occurrence of arrhythmia and provide protection for the patient’s prognosis., 百拇医药(钟玉婷 田克钧)
【关键词】 围术期;恶性心律失常;临时心脏起搏器;心脏功能
DOI：10.14163/j.cnki.11-5547/r.2020.30.003
Cause analysis and countermeasures of malignant arrhythmia caused by temporary cardiac pacemaker during perioperative period ZHONG Yu-ting， TIAN Ke-jun. Department of Anesthesia， First Affiliated Hospital of Gannan Medical College， Ganzhou 341000， China
【Abstract】 Objective To study the cause of malignant arrhythmia caused by temporary cardiac pacemaker during perioperative period. Methods Among 90 patients who were treated with temporary cardiac pacemaker during perioperative period， 11 patients with malignant arrhythmia were set as group A， and 79 patients without malignant arrhythmia were set as group B. The clinical data of the two groups were analyzed and sorted out， and the causes of malignant arrhythmia caused by temporary cardiac pacemaker during perioperative period were statistically analyzed. Results There was no statistically significant difference in gender， type of operations and complications between the two groups (P>0.05). There was statistically significant difference in age， normal pacemaker pacing， electrode shedding， abnormal electrode discharge， preoperative left ventricular end diastolic diameter (LVEDD)， preoperative left ventricular ejection fraction (LVEF)， preoperative Hamilton anxiety scale (HAMA) score， Hamilton depression scale (HAMD) score， battery， loose or disconnected interface， reasonable parameters， electrode shift， use of electrocautery， surgical position， mode situation between the two groups (χ2=4.060， 4.729， 5.174， 9.131， 3.925， 4.780， 8.577， 6.512， 10.340， 6.221， 8.054， 10.957， 6.038， 8.577， 7.557， P<0.05). Conclusion The use of temporary pacemakers during the perioperative period can cause malignant arrhythmia. If the cause of the arrhythmia can be fully grasped， relevant intervention measures can be formulated as soon as possible to reduce the occurrence of arrhythmia and provide protection for the patient’s prognosis., 百拇医药(钟玉婷 田克钧)