双腔心脏起搏器和单腔心脏起搏器治疗老年缓慢性心律失常的效果对比
|
摘要
目的:探讨双腔心脏起搏器和单腔心脏起搏器治疗老年缓慢性心律失常的优劣差异。方法:选取2016年1月-2017年9月本院收治的需用心脏起搏器治疗的老年缓慢性心律失常患者72例作为研究对象,按照随机数字表法将其分为VVI组和DDD组,各36例。VVI组置入单腔心脏起搏器治疗,DDD组置入双腔心脏起搏器治疗,对比两组治疗前和置入起搏器6个月后的心率(HR)、心脏指数(CI)、每搏输出量(SV)、每分心输出量(CO)、左室射血分数(LVEF),以及临床症状、生活质量评分和心功能分级情况。结果:治疗后,两组HR、CI、SV、CO、LVEF指标水平与治疗前对比均明显升高,且DDD组均明显高于VVI组,差异均有统计学意义(P<0.05)。治疗前两组各项临床症状评分对比,差异均无统计学意义(P>0.05);治疗后,两组各项临床症状评分与治疗前对比均明显升高,且DDD组均明显高于VVI组,差异均有统计学意义(P<0.05)。治疗后,DDD组的总体健康和所有项目总分均明显高于VVI组,心功能分级情况明显优于VVI组,差异均有统计学意义(P<0.05)。结论:在治疗老年缓慢性心律失常中应用双腔心脏起搏器的临床效果明显优于单腔心脏起搏器,能更好地改善患者的症状和生活质量。
Objective:To explore the the advantages and disadvantages difference of dual chamber pacemaker and single chamber pacemaker in the treatment of elderly patients with bradyarrhythmias.Method:Atotal of 72 elderly patients with bradyarrhythmias who were treated with cardiac pacemaker in our hospital from January 2016 to September 2017 were selected as the research objects.According to the random number table method,they were divided into VVI group and DDD group 36 cases in each group.VVI group was implanted with single chamber pacemaker,DDD group was implanted with dual chamber pacemaker.The heart rate(HR),cardiac index(CI),stroke output(SV),cardiac output(CO),left ventricular ejection fraction(LVEF),clinical symptoms,quality of life scores before and after 6 months of pacemaker implantation and cardiac function classification between the two groups were compared.Result:After treatment,the levels of HR,CI,SV,CO and LVEF in two groups were significantly higher than those before treatment,and DDD group were significantly higher than those in VVI group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the scores of clinical symptoms between the two groups(P>0.05);after treatment,the scores of clinical symptoms in two groups were significantly higher than those before treatment,and DDD group were significantly higher than those in VVI group,the differences were statistically significant(P<0.05).After treatment,the overall health and total scores of all items in DDD group were significantly higher than those in VVI group,and the classification of cardiac function in DDD group was significantly better than that in VVI group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of dual chamber pacemaker is better than single chamber pacemaker in the treatment of senile bradyarrhythmia,which can better improve the symptoms and quality of life of patients.
Objective:To explore the the advantages and disadvantages difference of dual chamber pacemaker and single chamber pacemaker in the treatment of elderly patients with bradyarrhythmias.Method:Atotal of 72 elderly patients with bradyarrhythmias who were treated with cardiac pacemaker in our hospital from January 2016 to September 2017 were selected as the research objects.According to the random number table method,they were divided into VVI group and DDD group 36 cases in each group.VVI group was implanted with single chamber pacemaker,DDD group was implanted with dual chamber pacemaker.The heart rate(HR),cardiac index(CI),stroke output(SV),cardiac output(CO),left ventricular ejection fraction(LVEF),clinical symptoms,quality of life scores before and after 6 months of pacemaker implantation and cardiac function classification between the two groups were compared.Result:After treatment,the levels of HR,CI,SV,CO and LVEF in two groups were significantly higher than those before treatment,and DDD group were significantly higher than those in VVI group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the scores of clinical symptoms between the two groups(P>0.05);after treatment,the scores of clinical symptoms in two groups were significantly higher than those before treatment,and DDD group were significantly higher than those in VVI group,the differences were statistically significant(P<0.05).After treatment,the overall health and total scores of all items in DDD group were significantly higher than those in VVI group,and the classification of cardiac function in DDD group was significantly better than that in VVI group,the differences were statistically significant(P<0.05).Conclusion:The clinical effect of dual chamber pacemaker is better than single chamber pacemaker in the treatment of senile bradyarrhythmia,which can better improve the symptoms and quality of life of patients.
引文
[1]中华医学会心血管病学分会,中国生物医学工程学会心律分会,中国医师协会循证医学专业委员会,等.心律失常紧急处理专家共识[J].中华心血管病杂志,2013,41(5):363-376.
[2]李健,史扬,王玉堂,等.老年患者起搏器置入术后主动固定电极参数可变性分析[J].中华老年心脑血管病杂志,2013,15(10):1047-1049.
[3]刘志勇,刘静,刘千.老年患者起搏器置入术后囊袋感染的临床分析[J].中华医院感染学杂志,2014,24(5):1220-1222.
[4]来欣,王晞.心脏起搏器的临床应用进展[J].疑难病杂志,2014,34(11):1197-1199.
[5]刘会君,张三林,卫世强.双腔心脏起搏器治疗缓慢性心律失常疗效及对心功能的影响[J].医药论坛杂志,2016,37(5):55-56.
[6]张杉,白梅,何维玉,等.舒适护理在高龄患者永久心脏起搏器治疗中的效果观察[J].心肺血管病杂志,2014,33(5):726-728.
[7]王辉,刘震宇.阿司匹林预防心房颤动患者卒中的地位下降[J].中国循环杂志,2013,28(2):159.
[8]范晓莹.双腔心脏起搏器对缓慢性心律失常患者心功能的影响[J].中国医疗器械信息,2016,22(8):1-2.
[9]陈柯萍.心血管急症救治(6)缓慢性心律失常的诊断和处理(续5)[J].中国循环杂志,2014,29(4):244-246.
[10]李上海,吴铿,李腾,等.远程监测起搏器在缓慢性心律失常患者中的应用[J].广东医科大学学报,2016,34(1):52-55.
[11]南征.心脏起搏器在缓慢性心律失常患者中的应用效果[J].中国实用医药,2014,9(32):78.
[12]潘娅萍,高彦,吕云.双腔心脏起搏器对缓慢性心律失常患者心功能的疗效分析[J].中外医疗,2013,32(31):51-52.
[13]林智海.双腔心脏起搏器对缓慢性心律失常患者心功能的影响[J].心血管康复医学杂志,2014,23(3):321-324.
[14]马元凤.双腔心脏起搏器治疗老年缓慢性心律失常患者的临床疗效分析[J].河北医学,2018,24(3):463-466.
[15]乔青,徐伟,李晓宏,等.DDD起搏器心房起搏比例对植入后心房高频事件的影响[J].实用医学杂志,2013,29(19):3175-3177.
[16]邸军军,岳玉国,赵新国,等.冠状动脉造影于缓慢性心律失常患者起搏器安置术中的应用价值[J].浙江创伤外科,2017,22(3):569-570.
[17]樊晓寒,姚焰.起搏器术后心房颤动现状分析[J].中国循环杂志,2014,29(10):852-854.
[18]陈晓丽,任学军,韩智红,等.老年患者双腔起搏器置入术后发生心房颤动的相关因素分析[J].心肺血管病杂志,2017,36(3):190-193.
[19]石兆云.双腔起搏器植入在缓慢性心律失常并发心力衰竭中的应用价值[J].现代诊断与治疗,2013,24(8):1715-1716.
[20]刘贺,刘吉超,王静.双腔心脏起搏器治疗老年缓慢性心律失常患者的疗效观察[J].中国医疗器械信息,2017,23(15):91-92.
[2]李健,史扬,王玉堂,等.老年患者起搏器置入术后主动固定电极参数可变性分析[J].中华老年心脑血管病杂志,2013,15(10):1047-1049.
[3]刘志勇,刘静,刘千.老年患者起搏器置入术后囊袋感染的临床分析[J].中华医院感染学杂志,2014,24(5):1220-1222.
[4]来欣,王晞.心脏起搏器的临床应用进展[J].疑难病杂志,2014,34(11):1197-1199.
[5]刘会君,张三林,卫世强.双腔心脏起搏器治疗缓慢性心律失常疗效及对心功能的影响[J].医药论坛杂志,2016,37(5):55-56.
[6]张杉,白梅,何维玉,等.舒适护理在高龄患者永久心脏起搏器治疗中的效果观察[J].心肺血管病杂志,2014,33(5):726-728.
[7]王辉,刘震宇.阿司匹林预防心房颤动患者卒中的地位下降[J].中国循环杂志,2013,28(2):159.
[8]范晓莹.双腔心脏起搏器对缓慢性心律失常患者心功能的影响[J].中国医疗器械信息,2016,22(8):1-2.
[9]陈柯萍.心血管急症救治(6)缓慢性心律失常的诊断和处理(续5)[J].中国循环杂志,2014,29(4):244-246.
[10]李上海,吴铿,李腾,等.远程监测起搏器在缓慢性心律失常患者中的应用[J].广东医科大学学报,2016,34(1):52-55.
[11]南征.心脏起搏器在缓慢性心律失常患者中的应用效果[J].中国实用医药,2014,9(32):78.
[12]潘娅萍,高彦,吕云.双腔心脏起搏器对缓慢性心律失常患者心功能的疗效分析[J].中外医疗,2013,32(31):51-52.
[13]林智海.双腔心脏起搏器对缓慢性心律失常患者心功能的影响[J].心血管康复医学杂志,2014,23(3):321-324.
[14]马元凤.双腔心脏起搏器治疗老年缓慢性心律失常患者的临床疗效分析[J].河北医学,2018,24(3):463-466.
[15]乔青,徐伟,李晓宏,等.DDD起搏器心房起搏比例对植入后心房高频事件的影响[J].实用医学杂志,2013,29(19):3175-3177.
[16]邸军军,岳玉国,赵新国,等.冠状动脉造影于缓慢性心律失常患者起搏器安置术中的应用价值[J].浙江创伤外科,2017,22(3):569-570.
[17]樊晓寒,姚焰.起搏器术后心房颤动现状分析[J].中国循环杂志,2014,29(10):852-854.
[18]陈晓丽,任学军,韩智红,等.老年患者双腔起搏器置入术后发生心房颤动的相关因素分析[J].心肺血管病杂志,2017,36(3):190-193.
[19]石兆云.双腔起搏器植入在缓慢性心律失常并发心力衰竭中的应用价值[J].现代诊断与治疗,2013,24(8):1715-1716.
[20]刘贺,刘吉超,王静.双腔心脏起搏器治疗老年缓慢性心律失常患者的疗效观察[J].中国医疗器械信息,2017,23(15):91-92.