经导管室间隔缺损介入封堵术前后动态心电图临床分析

目的探讨经导管封堵术治疗室间隔缺损前后动态心电图特点及临床意义。方法选择在广西壮族自治区人民医院成功施行经导管室间隔缺损介入封堵术（TCVSD）患者89例,分别于术前1d及术后1、30d描记24h动态心电图。结果①TCVSD术后1d总心搏、室上性、室性早搏、（非）阵发性室速发生率明显高于术前1d（P〈0.05）;TCVSD术后30d各种心律失常发生率与术前1d对比差异无统计学意义（P〉0.05）;②TCVSD前1d与术后7d内传导阻滞发生率差异有统计学意义（P〈0.01）,术后30d随访传导阻滞发生率与术前差异无统计学意义（P〉0.05）。③QT间期、QTd术前1d与术后1、30d比较逐渐延长（P〈0.05）;电轴术后1d与术前1d比较左偏幅度增大（P〈0.01）;术后30d与术前1d比较无明显变化（P〉0.05）。结论TCVSD术后多种因素可影响心律失常的发生类型及发生率,但这种改变多为暂时性可恢复正常,故经导管封堵术治疗室间隔缺损是一种安全有效的方法。近期疗效肯定,中远期疗效尚需进一步观察。

Analysis of holter before and after transeatheter closure of ventricular septal defect

Objective To summarize the change of hoher and clinical signification before and after transcatheter closure of ventricular septal defect. Methods 89 cases who underwent transcatheter closure of ventricular septal defect（TCVSD） were selected,24 h hoher were taken at 1 .day before and 1 day,30 days after TCVSD. Results ①There was significant variation of heart rate, premature ventricular complex, premature atria complex and Ventricular tachycardia at 1 day before and 1 day after TCVSD （ P 〈 0. 05 ）. There was no significant variation at 1 day before and 30 days after TCVSD（ P 〉 0. 05 ）. ②There was significant variation of various block at 1 day before and 7 days after TCVSD（P 〈0. 01 ）. There was no significant variation at 1 day before and 30 days after TCVSD（ P 〉 0. 05 ）. ③QTd increased after TCVSD（ P 〈 0. 05 ）, axis was deviated left at 1 day after TCVSD （ P 〈 0.05 ）, it could recovered at 30 days after TCVSD （ P 〉 0. 05 ）. Conclusions Many factors may affect the types and rates of arrhythmia after TCVSD. a majority of arrhythmia could be recovered, transcatheter closure of congenital heart disease is a safe effective and dependable treatment, but the treatment should be observed in the future.