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目的 :观察右室不同起搏部位对老年病窦综合征患者左室收缩功能的影响。方法 :选取2013年3月~2015年3月在我院治疗并接受起搏器植入手术的90例老年病窦综合征患者为观察对象,根据其起搏器植入部位分为右室流出道组和右室心尖组,每组各45例患者。观察两组患者手术前后左心室收缩同步性和整体收缩功能;比较两组患者手术前后血流动力学的改变。结果 :两组患者手术前左心室收缩同步性无明显差别,手术后,右室心尖组Tmsv-16-SD、Tmsv-16-Dif等左心室同步收缩性指标较右流出道组明显延长,而右流出道组患者的上述指标较手术前无明显变化;两组患者手术前左心室整体收缩功能无明显差别,手术后,两组患者的左心室整体收缩功能均较术前无明显改变,且两组间比较差别无统计学意义;手术前两组患者的血流动力学无明显差别,手术后,两组患者的心输出量(CO)均较术前无明显改变,而右室心尖组的FS和舒张期二尖瓣流速较术前明显降低,右流出道组的上述指标较术前差别无统计学意义。结论 :起搏器植入右室流出道较右室尖部可更好地维持左心室收缩功能的同步性和血流动力学的稳定性,提示右室流出道起搏器植入对患者更为安全。
Objective: To observe the effects of different right ventricular pacing sites on left ventricular systolic function in elderly patients with sinus syndrome. Methods: From March 2013 to March 2015 in our hospital for treatment and received pacemaker implantation in 90 cases of senile sinus syndrome were selected as the object of observation, according to their pacemaker implantation site is divided into right ventricular outflow Road group and right ventricular apex group, each group of 45 patients. The left ventricular systolic and systolic function were observed before and after operation. The hemodynamic changes were compared between the two groups before and after operation. Results: There was no significant difference in systolic left ventricular systolic synchrony between the two groups. After operation, systolic left ventricular systolic indexes such as Tmsv-16-SD and Tmsv-16-Dif were significantly prolonged in right ventricular apical group than in right de novo group There was no significant difference between the two groups before operation; the left ventricular systolic function of the two groups had no significant difference before operation. After the operation, the overall left ventricular systolic function in both groups had no significant changes There was no significant difference between the two groups. There was no significant difference in hemodynamics between the two groups before surgery. After operation, the cardiac output (CO) Of FS and diastolic mitral flow was significantly lower than preoperative, right outflow tract of the above indicators were no significant difference compared with preoperative. CONCLUSIONS: The pacemaker implanted right ventricular outflow tract better than the right ventricular tip systolic function and hemodynamic stability, suggesting that right ventricular outflow tract pacemaker implantation of patients more For safety.