永久性心脏起搏器植入对心力衰竭的干预效果研究

doi:10.3760/cma.j.issn.1007-1245.2022.20.026

摘要/Abstract

摘要： 目的　分析希浦系统起搏（HPCSP）对心力衰竭的干预效果。方法　选取2020年4月至2022年4月在商丘市第一人民医院接受治疗的80例心力衰竭患者，按随机数字表法分为参考组（40例）和HPCSP组（40例）。参考组男26例、女14例，年龄（55.31±5.62）岁，给予双心室起搏；HPCSP组男23例、女17例，年龄（54.78±5.57）岁，在常规治疗的基础上给予HPCSP。比较两组心功能［左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF）］，血压［舒张压（DBP）、收缩压（SBP）］，心率（HR），起搏参数（阻抗、阈值、感知），QRS时限，生活质量［健康调查简表（SF-36）］及并发症发生情况。计量资料采用t检验，计数资料采用χ²检验。结果　两组术后LVEDD［（59.45±6.01）mm、（64.37±6.52）mm］、HR［（75.42±7.61）次/min、（80.64±8.15）次/min］均明显低于术前［（70.23±7.26）mm、（69.58±7.21）mm、（90.45±9.31）次/min、（89.38±9.14）次/min］（均P<0.05）；HPCSP组术后阻抗［（510.79±51.26）Ω］明显低于术前［（541.37±55.23）Ω］（P<0.05），且与参考组比较，HPCSP组明显降低（P<0.05）；两组LVEF、LVESD、DBP、SBP及SF-36评分均明显升高（均P<0.05），且与参考组比较，HPCSP组明显升高（均P<0.05）；两组手术前后阈值、感知比较差异均无统计学意义（均P>0.05）；与术前比较，两组术后QRS时限明显缩短（均P<0.05），且与参考组比较，HPCSP组明显缩短（P<0.05）。HPCSP组术后并发症发生率为7.50%（3/40），明显低于参考组27.50%（11/40），差异有统计学意义（χ²=4.242，P=0.039）。结论　HPCSP用于心力衰竭患者可有效保证心室同步收缩，提高生活质量，安全有效。

关键词: 心力衰竭, 希浦系统起搏, 心功能

Abstract: Objective　To analyze the intervention effect of His-Purkinje conductive system pacing (HPCSP) for heart failure. Methods　Eighty patients with heart failure treated in Shangqiu First People's Hospital from April 2020 to April 2022 were gathered and were grouped into a reference group (40 cases) and a HPCSP group (40 cases) by the random number table. There were 26 males and 14 females in the reference group, with an age of (55.31±5.62) years old; there were 23 males and 17 females in the HPCSP group, with an age of (54.78±5.57) years old. The reference group was given biventricular pacing, and the HPCSP group was given HPCSP on the basis of conventional treatment. The cardiac function [left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF)], blood pressure [diastolic blood pressure (DBP) and systolic blood pressure (SBP)], heart rate (HR), pacing parameters (impedance, output, and sense), QRS duration, quality of life [Shot Form 36 Health Survey (SF-36)], and complications were compared between the two groups. t test was used for the measurement data, and chi-square test was used for the count data. Results　The LVEDD [(59.45±6.01) mm and (64.37±6.52) mm] and HR [(75.42±7.61) beats/min and (80.64±8.15) beats/min] in both groups after operation were significantly lower than those before operation [(70.23±7.26) mm, (69.58±7.21) mm, (90.45±9.31) beats/min, and (89.38±9.14) beats/min] (all P<0.05). The impedance of the HPCSP group after operation was significantly lower than that before operation [(510.79±51.26) Ω vs. (541.37±55.23) Ω] (P<0.05), and compared with that in the reference group, the impedance of the HPCSP group was significantly lower (P<0.05). The LVEF, LVESD, DBP, SBP, and SF-36 score in the two groups were significantly increased (all P<0.05), and compared with those in the reference group, those in the HPCSP group were significantly increased (all P<0.05). There were no statistically significant differences in the output and sense between the two groups before and after operation (all P>0.05). The QRS duration in the two groups after operation were significantly shorter that those before operation (both P<0.05), and compared with that in the reference group, the QRS duration in the HPCSP group was significantly shorter (P<0.05). The incidence of postoperative complications in the HPCSP group was 7.50% (3/40), which was significantly lower than that in the reference group [27.50% (11/40)], with a statistically significant difference (χ²=4.242, P=0.039). Conclusion　HPCSP can effectively ensure synchronous ventricular contraction in patients with heart failure, and improve their quality of life, which is safe and effective.

Key words: Heart failure, His-Purkinje conductive system pacing, Cardiac function

陈舒欣. 永久性心脏起搏器植入对心力衰竭的干预效果研究[J]. 国际医药卫生导报, 2022, 28(20): 2932-2936.

Chen Shuxin. Study on intervention effect of permanent pacemaker implantation for heart failure[J]. International Medicine and Health Guidance News, 2022, 28(20): 2932-2936.

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