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埋置心脏复律除颤器患者的随访与药物辅助治疗 |
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商丽华 胡大一 杨新春 张建军
摘要 为了解埋藏式心脏复律除颤器(ICD)埋置后病人及ICD工作的情况，以便及时调整ICD的诊断及治疗程序从而给予病人更适当的治疗，对8例接受ICD治疗的病人分别在出院前及出院后每3～6个月进行一次随访观察。8例病人随访11.4±7.0个月，共发生心律失常事件25次。抗心动过速起搏(ATP)治疗67次，第1次成功22次，占32.8%。高能量除颤10次，第1次成功6次，占60.0%。总成功率91.3%。1例病人室性心动过速发作频繁、1例病人ICD不能有效终止心动过速、2例病人出现甲状腺功能障碍。经调整药物及ICD工作方式后，心动过速控制良好。表明对接受ICD治疗的病人进行定期随访十分重要，及时调整ICD程序设置和辅以药物治疗，可提高ICD治疗的成功率。
关键词 心脏复律除颤器，埋藏式 心动过速，室性 随访
Follow-up and Management for Patients With Implantable Cardioverter-Defibrillators
Shang Lihua,Hu Dayi,Yang Xinchun,et al.
(The Heart Center,Beijing Red Cross Chaoyang Hospital,Beijing,100020)
Abstract The results of the patients with implantable cardioverter-defibrillator(ICD) was investigated in order to give them a approprate treatment by changeing the programsetting and drug administration.Follow-up for 8 patients after ICD implantation was conducted before discharge from hospital and every 3～6 months after discharge.Results:Averaged period of follow-up was 11.4±7.0 months.Total arrhythmic events were 25 times,the success rate of antiarrhythmic pacing(ATP) and high energy defibrillation were 32.8%(22/67) and 60.0%(6/10) respectively.Of the patients,one had frequent ventricular tachycardia attack,one had a refractory response to ICD therapy,two presented thyrogenic disfunction and these problems were solved after regulating the setting and drug administration.Conclusion:Follow-up is important for patient with ICD.It is helpful to guide doctors to modify the work setting of ICD and drug administration in time which in turn to increase the success rate of ICD in terminating arrhythmic events.
Key words Cardioverter-defibrillator,implantable Tachycardia,ventricular Follow-up
埋藏式心脏复律除颤器(ICD)1980年应用于临床以来发展迅速，已成为治疗恶性室性心律失常的重要手段。对埋置ICD的病人进行长期随访十分重要。现将我院埋置ICD的8例患者作一报道。
1 资料与方法
1.1 观察对象 自1996年4月～1998年1月在我院埋置ICD的患者共8例(室性心动过速6例、心室颤动2例)。男性6例、女性2例。年龄51±14.2(30～68)岁。基础心脏病诊断：冠心[1] [2] 下一页
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