完全性肺静脉异位连接术后引起心律失常的原因探讨

目的探讨完全性肺静脉异位连接(TAPVC)术后心律失常的原因和治疗措施.方法回顾性分析1999年1月～2002年6月TAPVC 26例患者的临床资料.心上型16例(61.54%),心内型9例(34.61%),混合型1例(3.85%).结果术后早期(30 d)死亡2例(7.69%).术后心律失常为室上性心律失常12例(46.15%),其中窦性心动过缓5例(19.23%),交界区性心律5例(19.23%),房性过早搏动1例(3.84%),Ⅱ度房室传导阻滞1例(3.84%).心上型完全性肺静脉异位连接矫治术后的心律失常发生率为56.25%(9/16例).结论完全性肺静脉异位连接早期手术疗效满意.术后心律失常发生率较高,应及时发现和处理.

Investigation of arrhythmia caused by correction of total anomalous pulmonary venous connection

Objective To investigate the reasons of arrhythmia caused by total correction of total anomalous pulmonary venous connection (TAPVC).Methods From January 1999 to June 2002,total correction of TAPVC was performed in 26 cases (male 16,female 10).Three operative types were used for the treatment, supracardiopulmonary type in 16 patients (61.54%), intracardiac type in 9 patients (34.61%) and mixed type in 1 patients (3.85%). Results The early mortality after surgery (within 30 days) for TAPVC was 7.69%(2/26). The types of arrhythmia were classified as: supraventricular arrhythmia in 12 cases (46.15%), sinus bradycardia in 5 cases (19.23%), relay cardiac rhythm in 5 cases (19.23%), atria extrasystole in 1 case (3.84%), II degree atrioventricular block in 1 case ( 3.84%). The morbidity of arrhythmia after supracardiopulmonary type operation was 56.25% (9 of 16 cases). Conclusion The results were satisfactory after early surgical treatment for the TAPVC. The morbidity was higher after operation and diagnosis and management should be prompt.