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目的探讨经导管室间隔缺损封堵术围术期出现的心律失常的处理方法。方法对182例先天性室间隔缺损的患儿进行室间隔缺损封堵术,经心电监测、常规心电图检查和24h动态心电图检查,对围术期出现心律失常的31例患儿根据病情进行不同的处理。结果本组患儿无死亡,3例术后出现三度房室传导阻滞的患儿安装了临时起搏器,2例恢复窦性心律,1例转外科手术,外科术后恢复窦性心律。1例术中出现三度房室传导阻滞的患儿转心外科手术。左束支传导阻滞及二度房室传导阻滞的病例均行内科治疗并恢复,其他非严重心律失常病例给予内科对症治疗。结论经导管封堵室间隔缺损围术期心律失常的发生率相对较高,围术期的心电监测十分重要,术后要进行密切的随访观察。
Objective To investigate the treatment of arrhythmia during perioperative closure of transcatheter ventricular septal defects. Methods Ventricular septal defect occlusion was performed in 182 children with congenital ventricular septal defect. The electrocardiogram (ECG), routine electrocardiogram (ECG) and 24h dynamic electrocardiogram (ECG) were used in 31 children with arrhythmia during perioperative period. Processing. Results There were no deaths in this group of children. Three children with third degree AV block after operation had temporary pacemaker installed, two patients had sinus rhythm recovery, one patient had surgery, and sinus rhythm was recovered after surgery . A case of third degree atrioventricular block in children with heart surgery. Left bundle branch block and second degree atrioventricular block were treated with medical treatment and recovery, other non serious cases of arrhythmia given symptomatic treatment of internal medicine. Conclusion The incidence of perioperative arrhythmia after transcatheter closure of ventricular septal defect is relatively high. Perioperative ECG monitoring is very important, and follow-up observation is required after operation.