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目的:研究探讨动态心电图在埋藏式心脏起搏器植入术后临床监测过程中的应用价值。方法:选择2015年6月-2017年6月在杭州市中医院进行埋藏式心脏起搏器植入术的128例患者为研究对象,在埋藏式心脏起搏器植入术后2周,分别对患者进行常规的心电图检查和采用连续24h的动态心电图监测,对比分析常规心电图与动态心电图对患者起搏器功能异常以及患者因起搏器植入引起的心律失常的检出率,以此评价动态心电图在心脏起搏器植入术后的临床应用价值。结果:(1)动态心电图检出起搏器感知和功能异常患者56例,常规心电图检出起搏器感知和功能异常患者8例,组间比较差异有统计学意义(P<0.05)。(2)动态心电图共检出37例患者出现由起搏器引起的心律失常,而常规心电图则检出5例,组间比较差异有统计学意义(P<0.05)。结论:动态心电图监测可准确彻底地发现术后患者起搏器运行的异常情况,能够准确预测术后不良事件的发生情况。动态心电图的应用可为起搏器的故障排除和仪器参数优化提供可靠的依据,可在患者术后心功能状态评估和不良事件的监测过程中发挥重要作用。
Objective: To investigate the clinical value of ambulatory electrocardiogram (ECG) in clinical monitoring after implanted pacemaker implantation. Methods: A total of 128 patients undergoing implanted pacemaker implantation in Hangzhou Hospital of Traditional Chinese Medicine from June 2015 to June 2017 were selected as study subjects. Two weeks after implantation of implanted pacemaker, The patients underwent routine electrocardiogram examination and continuous 24h electrocardiogram monitoring, comparative analysis of conventional electrocardiogram and ambulatory electrocardiogram on patients with pacemaker dysfunction and patients with pacemaker implantation induced arrhythmia detection rate, thus evaluating Clinical Value of Holter in Cardiac Pacemaker Implantation. Results: (1) There were 56 cases of ambulatory electrocardiogram (ECG) detection and abnormality in pacemaker, 8 cases of conventional electrocardiogram were detected in patients with abnormal pacemaker perception and function, the difference was statistically significant (P <0.05). (2) There were 37 cases of arrhythmia caused by pacemaker in ambulatory electrocardiogram, while 5 cases were detected in routine electrocardiogram, the difference was statistically significant (P <0.05). Conclusion: Holter monitoring can accurately and completely find out the abnormality of pacemaker operation in postoperative patients, and accurately predict the occurrence of postoperative adverse events. The application of Holter can provide a reliable basis for the troubleshooting of pacemaker and the optimization of instrument parameters. It can play an important role in the assessment of postoperative cardiac function and the monitoring of adverse events.