小儿心导管、心血管造影检查中心律失常相关因素及防治

目的　探讨小儿先天性心脏病(先心病)心导管和/或心血管造影检查中心律失常的发生率、相关因素以及防治措施。方法　512例小儿先心病,常规心导管和/或心血管造影检查,对术中489例不同程度心律失常发生的相关因素及严重心律失常的防治进行分析。结果　心律失常发生率为973%,其中严重心律失常占62%。导管位于右室流出道及三尖瓣口处心律失常发生率最高,分别为307%,261%。严重心律失常31例,其中紫绀型复杂先心病占645%,左向右分流先心病并重度肺动脉高压者占355%。结论　心导管和/或心血管造影检查中,严重心律失常发生的相关因素有心脏本身畸形的程度、肺动脉高压的轻重、心功能状态以及造影剂用量、种类、速度等。术中一旦出现严重心律失常,需立即消除诱因,积极采取药物治疗等急救措施

Analysis of Correlative Factors and Prevention of Arrhythmia in Cardiac Catheterization and Cardioangiography of Children

Objective To investigate the incidence,correlative factors and prevention of arrhythmia in cardiac Catheterization and/or cardioangiographic examination in Children congenital heart disease.Methods arrhythmia occurred in 489 out of 512 cases of Children congenital heart disease during routine catheterization and/or cardioangiographic examination.The correlative factors of arrhythmia and prevention of severe arrhythmia were analyzed.Results The incidence of arrhythmia was 97 3%,in which 6 2% was severe.The incidence was 30 7% and 26 1% when the catheter was placed in right ventricular outflow tract and tricuspid orifice,which was much higher than that in other place.Thirty one cases suffered from severe arrhythmia,among which complicated cyanotic congenital heart disease accounted for 64 5% ,left to right shount conenital heart disease with severe pulmonary hypertension accounted for 35 5%.Conclusion The correlative factors of severe arrhythmia include the extent of malformation of the heart,the degree of pulmonary hypertension,the state of the cardiac function,the dosage,categories and the speed of injecton of contrast etc.Once severe arrhythmia occurred during operation,the first aid measures must be taken such as eliminating causes and treating with remedy,etc.