论文部分内容阅读
为评价膜部室间隔缺损治疗后心律失常的发生率和预后,对比分析介入组(358例)和外科手术组(50例)住院中和出院时的心电图改变,并以出院时心电图改变为基础,进行1、3、6和12个月连续随访,介入组和手术组分别随访到180例和50例。结果表明,两组住院中除束支阻滞外,其他心律失常均在出院前消失。出院时介入组完全性右束支阻滞(CRBBB)发生率5%,不完全性右束支阻滞(IRBBB)10.1%,左前分支阻滞(LAFB)2.8%,IRBBB并LAFB1.7%,CRBBB并LAFB0.6%;外科手术组CRBBB和IRBBB分别为26%和28%,显著高于介入组。随访一年结束时,介入组CRBBB、IRBBB、CRBBB并LAFB和Ⅲ度房室传导阻滞发生率依次为3.3%、6.1%、1.7%和0.56%,而外科手术组则既无改善也未发生新的改变。结论:两组治疗的临床效果一致,但是介入治疗比外科手术更安全;介入治疗产生的IRBBB和LAFB是良性阻滞,多在术后6～12个月消失,而CRBBB或CRBBB并LAFB则需长期随访。
To evaluate the incidence and prognosis of ventricular arrhythmias after ventricular septal defect treatment, the electrocardiographic changes during and after hospitalization were compared between the intervention group (358 cases) and the surgical group (50 cases). Based on the ECG changes after discharge, The patients were followed up for 1, 3, 6, and 12 months. The intervention group and the operation group were followed up to 180 cases and 50 cases. The results showed that in addition to the two groups of hospitalized bundle branch block, other arrhythmias disappeared before discharge. At discharge, 5% of patients with complete right bundle branch block (CRBBB), 10.1% of incomplete right bundle branch block (IRBBB), 2.8% of left anterior branch block (LAFB), 1.7% of IRBBB and LAFB, CRBBB and LAFB 0.6%; surgical group CRBBB and IRBBB were 26% and 28%, significantly higher than the intervention group. At the end of one year follow-up, the incidences of CRBBB, IRBBB, CRBBB, LAFB and Ⅲ degree AV block were 3.3%, 6.1%, 1.7% and 0.56% respectively in the intervention group, while those in the surgery group were neither improved nor New change. Conclusion: The clinical effects of the two groups are the same, but the interventional treatment is safer than the surgery. The IRBBB and LAFB produced by the interventional therapy are benign and often disappear 6 to 12 months after the operation, while CRBBB or CRBBB and LAFB are required Long-term follow-up.