摘要
目的分析肥厚型梗阻性心肌病化学消融术后1周内的心电图变化与临床疗效。方法回顾性分析2013年6月至2015年6月廊坊市人民医院接受经皮经室间隔心肌化学消融术治疗的75例肥厚型梗阻性心肌病患者的临床资料。比较术前与术后1周内的QT间期、QRS时间、RV5+SV1值变化及主要心律失常类型,观察患者超声心动图的变化。结果术后1周,肥厚型梗阻性心肌病患者左心室高电压、左前分支阻滞比例低于术前[36.0%(27/75)比53.3%(40/70),2.7%(2/75)比12.0%(9/75)],完全性右束支传导阻滞、异常Q波比例高于术前[41.3%(31/75)比6.7%(5/75),42.7%(32/75)比26.7%(20/75)],差异有统计学意义(P<0.05)。术后1周,肥厚型梗阻性心肌病患者左心室舒张末期容积、左心室收缩末期容积大于术前[(77±21)m L比(70±20)m L,(32±8)m L比(29±10)m L],纽约心脏病协会心功能分级低于术前[(1.5±0.3)级比(3.4±0.4)级],差异有统计学意义(P<0.05)。结论大多数肥厚型梗阻性心肌病患者化学消融术后心电图发生明显改变,但并不影响手术的治疗效果,患者的临床症状及舒张功能得到明显改善,无严重并发症发生。
Objective To analyze the electrocardiographic（ ECG） changes and efficacy of percutaneous transluminal septal myocardialablation（ PTSMA） on hypertrophic obstructive cardiomyopathy. Methods Total of 75 hypertrophic obstructive cardiomyopathy patients treated with PTSMA in Langfang People＇s Hospital from Jun. 2013 to Jun. 2015 were included for a retrospective analysis. Arrhythmia,QT interval,QRS time,RV5＋ SV1 value change and echocardiography before operation and within one week after operation were recorded and compared. Results One week after operation,left ventricular high voltage,left branch block ratio of hypertrophic obstructive cardiomyopathy patients were less than before[36. 0%（ 27 /75） vs53. 3%（ 40 /70）,2. 7%（ 2 /75） vs 12. 0%（ 9 /75） ],incomplete right bundle branch block,abnormal Q-wave ratio were higher than the preoperative[41. 3%（ 31 /75） vs 6. 7%（ 5 /75）,42. 7%（ 32 /75） vs26. 7%（ 20 /75） ],the differences were statistically significant（ P〈 0. 05）. One week after operation,left ventricular end-diastolic volume,left ventricular end-systolic volume,left ventricular end-systolic diameter of hypertrophic obstructive cardiomyopathy patients were greater than the before [（ 77 ± 21） m L vs（ 70 ±20） m L,（ 32 ± 8） m L vs（ 29 ± 10） m L],New York Heart Association functional grading lower than the preoperative[（ 1. 5 ± 0. 3） grade vs（ 3. 4 ± 0. 4） grade ],the difference was statistically significant（ P〈 0. 05）. Conclusion The ECG of most hypertrophic obstructive cardiomyopathy patients changes a lot after PTSMA,but it does not affect the treatment effect of surgery. Clinical symptoms and diastolic function of patients can be significantly improved without serious complications.
出处
《医学综述》
2016年第8期1625-1627,共3页
Medical Recapitulate
关键词
肥厚型梗阻性心肌病
经皮导管室间隔心肌化学消融术
心电图
Hypertrophic obstructive cardiomyopathy
Percutaneous transluminal septal myocardial ablation
Electrocardiogram
