风湿性心脏病瓣膜置换术后室性心律失常与心动过缓的关系

目的:研究风湿性心脏病患者瓣膜置换术后室性心律失常与心动过缓的相关性,以减少术后室性心律失常发生。方法:对178例风湿性心脏病瓣膜置换术前后室性心律失常患者心率、心律、心功能及电解质的变化进行比较,观察经异丙肾上腺素、654-2处理后对纠正室性心律失常的效果,并与无室性心律失常者进行对比。结果:两组患者术前心率、心功能、心律及电解质均无差异,但术后室性心律失常组较无室性心律失常组血糖含量明显偏低(P<0.05),心动过缓例数显著增多(P<0.01);给予异丙肾上腺素或654-2处理后有98%患者室性心律失常无复发。结论:风湿性心脏病患者瓣膜置换术后24 h内室性心律失常与心动过缓有关,提升心率可有效预防室性心律失常发生。

Relationship between Ventricular Arrhythmia and Bradycardia after Cardiac Valve Replacement

Objective To explore the relationship between ventricular arrhythmia and bradycardia after valve replacement in patients with rheumatic heart disease,so as to decrease the incidence of vcntricular arrhythmia in postopcration. Methods The heart rate, rhythm,function and electrolyte of ventricular arrhythmia patients with rheumatic heart disease were recorded and all the parameters before and after valve replacement were analyzed comparatively, the improvement of ventricular arrhythmia after treating with isoproterenol or 654-2 were observed and compared with the nonarrhythmia patients. Results The heart rate,function,rhythra and electrolyte had no significant difference between two groups,but the blcod sugar content in ventricular arrhythmia group was significantly lower than that in nonarrhythmia group after valve replacement（ P 〈 0.05 ）, bradycardia was significantly increased as well（ P 〈 0.01 ）. There was no recurrence in 98% patients with ventrieular arrhythmia after treating with isoproterenol or 654-2. Conclusion The occurrence of ventricular arrhythmia after valve replacement may relate with hradycardia in patients with rheumatic heart disease, increasing the heart rate may have protective effect on ventricular arrhythmia.