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本文报告了我院207例先天性心脏畸形的修补术在术中和术后所发生的19例外科性Ⅲ°AVB的病例资料,总的发生率为9.2%。指出预防这一严重并发症的关键在于术中避免损伤房室束和束支,它的主要危险性是低排、阿一斯氏综合症发作和心搏骤停;主要治疗措施是用人工起搏器直接控制心率和异丙肾上腺素的应用。心脏直视手术后暂时性Ⅲ°AVB和双束支阻滞,都存在着晚期发生Ⅲ°AVB和猝死的危险性,因而不能视为一种良性并发症,应密切随访观察。
This article reports 207 cases of congenital heart defects in our hospital during and after surgery occurred in 19 cases of surgical cases of Ⅲ ° AVB data, the overall incidence was 9.2%. Pointed out that the key to preventing this serious complication is the intraoperative avoid damage to atrioventricular bundle and bundle branch, its main risk is low row, Alsophia attack and cardiac arrest; The main treatment measures are artificial pacing Direct control of heart rate and isoproterenol applications. Temporary open III ° AVB and double bundle branch block after open heart surgery are associated with the risk of late stage Ⅲ ° AVB and sudden death and therefore can not be regarded as a benign complication and should be closely followed up.