World J Pediatr Congenit Heart Surg:小儿心脏术后早期心律失常

2018-04-12 李伟超 “罂粟花”微信号

本研究表明心律失常发生率较低,其中JET是最常见的,在TOF修复术中可以观察到更多的心律失常,但这些心律失常可以得到有效治疗。较高的亚里士多德评分,较长的手术时间,低血压,心动过速,高心肌收缩力评分和高血清乳酸水平与术后心律失常的发生有关。

背景与目的

心律失常是先天性心脏病心脏修复术后的一种相关并发症。

方  法

对369例18岁以下的患者进行择期心脏直视手术术后心律失常的发生率,诊断,潜在危险因素和治疗处理进行回顾性分析。所有儿童都被送入重症监护病房,并进行持续的心电图监测。分析患者心律失常发生因素,如亚里士多德基础复杂度评分,总手术持续时间,低血压,心动过速,血清乳酸水平和心肌收缩力评分。单因素分析评估这些因素与术后心律失常发生的关系。

结  果

25例(6.7%)患者发生心律失常。其中交界性异位心动过速(JET)15例(60%)是患者最常见的心律失常,其次为3例(12%)室上性心动过速,3例(12%)室性早搏,3例 (12%)血流动力学不稳定性室性心动过速和1例(4%)心房纤颤。13例患者出现不同程度的心脏阻滞。 亚里士多德评分(P = 0.014),总手术时间(P <0.01),低血压(P = 0.02),心率(每分钟搏动次数)(P = 0.001),血清乳酸水平(P = 0.04),术后早期肌力评分(P = 0.02)与心律失常发生相关。单独或与其他疾病相关的室间隔缺损手术,包括法洛四联症(TOF)和大动脉转位(TGA)被发现与心律失常风险较高相关。

结  论

本研究表明心律失常发生率较低,其中JET是最常见的,在TOF修复术中可以观察到更多的心律失常,但这些心律失常可以得到有效治疗。较高的亚里士多德评分,较长的手术时间,低血压,心动过速,高心肌收缩力评分和高血清乳酸水平与术后心律失常的发生有关。

原始出处:

Sahu M K, Das A, Siddharth B, et al. Arrhythmias in Children in Early Postoperative Period After Cardiac Surgery[J]. World J Pediatr Congenit Heart Surg, 2018, 9(1):38-46.

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    2018-05-04 feather89
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    2018-04-14 zhaojie88
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    2018-04-14 slcumt

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