论文部分内容阅读
目的:观察心脏再同步化治疗(CRT)对充血性心力衰竭患者心功能的影响。方法:对3例符合CRT适应证的充血性心力衰竭患者置入三腔起搏器,使心脏房室收缩趋向正常顺序、室间收缩同步化。3例患者均成功置入了三腔起搏器,左室电极靶血管2例位于左后侧静脉,1例右束支传导阻滞患者因为置入左后侧静脉膈肌跳动而改为心大静脉。结果:3个月时患者的胸闷气促症状明显改善,生活能够自理,心功能可达到NYHAⅡ级;QRS宽度均较术前缩短;术后3个月左室射血分数较术前提高,左室舒张末期内径减小;术后3个月程控仪测试参数显示,与置入三腔起搏器前相比夜间心率有所降低,活动度增加,心率变异性有所提高。结论:CRT通过改善心脏收缩的同步性,提高左室射血分数,从而改善心功能,提高生活质量和运动能力。
Objective: To observe the effect of cardiac resynchronization therapy (CRT) on cardiac function in patients with congestive heart failure. Methods: Three patients with congestive heart failure who conformed to CRT indications were implanted with a three-chamber pacemaker. The atrioventricular contractions in the heart tended to the normal order and systolic ventricular systole was synchronized. Three patients were successfully placed in the three-chamber pacemaker, left ventricular target vessel 2 cases in the left posterior vein, a case of right bundle branch block because of left ventricular diaphragmatic muscle into the beating and replaced by heart vein. Results: At 3 months, chest tightness symptoms were significantly improved, life was able to take care of themselves, heart function can reach NYHA Ⅱ level, QRS width shortened compared with preoperative; 3 months after left ventricular ejection fraction increased compared with preoperative, left Ventricular end diastolic diameter decreased; 3 months after the program-controlled instrument test parameters show that compared with before the implantation of the three-chamber pacemaker heart rate decreased at night, activity increased, heart rate variability has increased. CONCLUSION: CRT improves cardiac function and improves quality of life and motor performance by improving systolic synchrony and increasing left ventricular ejection fraction.