标题：植入型心律转复除颤器植入后的临床效果评价

      作者：朱振豪，刘西平，王冬梅，周佩玲，朱利芬    遵义医科大学附属医院心内科，贵州 遵义 563000

      卷次： 2019年30卷19期

      【摘要】 目的 评价植入型心律转复除颤器(ICD)植入术后的临床效果。方法 对遵义医科大学附属医院2008年6月至2018年11月收治的40例 ICD术后患者行门诊及电话随访，收集相关数据，分析患者术后心律失常的发作特点、术后并发症以及 ICD的治疗情况。结果 40例患者中男性24例，女性16例；年龄24~88岁，平均(61.2±15.4)岁；随访时间3~90个月，平均(36.1±25.6)个月。随访期间所有患者均被 ICD记录到有室性心律失常事件的发生，共计 764次，其中 230次非持续性室速事件自行停止，534次 ICD治疗事件，室速 462次(86.5%)，室颤 72次(13.5%)，抗心动过速起搏(ATP)终止室速391次(84.6 %)，低能量复律(CV)终止室速71次(15.4%)，高能量除颤(DF)终止室颤72次(100%)。6例(15 %)患者发生不恰当识别和放电共20次。术中高频电刀止血患者术后均无囊袋血肿及感染，采用压迫止血法患者术后囊袋感染2例。随访期间4例患者死亡，发生在术后3~30个月。结论 ICD植入后可有效地治疗室性心律失常，在术中使用高频电刀止血可减少术后囊袋出血感染的风险，优化 ICD编程及加强抗心律失常药物治疗可减少术后不恰当放电的发生。
      【关键词】 植入型心律转复除颤器；室速；室颤；随访；不恰当放电
      【中图分类号】 R54 【文献标识码】 A 【文章编号】 1003—6350（2019）19—2465—04

Clinical evaluation of implantable cardioverter defibrillator after implantation.
ZHU Zhen-hao, LIU Xi-ping,WANG Dong-mei, ZHOU Pei-ling, ZHU Li-fen. Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou,CHINA
【Abstract】 Objective To evaluate the clinical effect of implantable cardioverter defibrillator (ICD) implanta-tion. Methods Forty ICD patients in the Affiliated Hospital of Zunyi Medical University from June 2008 to November2018 were followed up by outpatient service and telephone, and relevant data were collected to analyze the characteris-tics of arrhythmias after surgery, postoperative complications and ICD treatment. Results There were 24 males and 16females in 40 patients, aged 24 to 88 years old, with an average of (61.2±15.4) years. The follow-up time ranged from 3to 90 months, with an average of (36.1±25.6) months. Ventricular arrhythmias occurred in all patients during the fol-low-up period, with a total of 764 times. There were 230 times of spontaneous termination of ventricular tachycardia,534 times of ICD treatment, 462 times (86.5%) of ventricular tachycardia, 72 times (13.5%) of ventricular fibrillation,391 times (84.6%) of antitachycardia pacing (ATP) terminating ventricular tachycardia, 71 times (15.4%) of terminationof ventricular tachycardia with low energy cardioversion (CV), 72 times (100%) of defibrillation (DF) terminating ven-tricular fibrillation, and 20 times of improper identification and discharge therapy in 6 patients (15%). No hematoma andinfection was found in patients with high frequency electrosurgical hemostasis during operation, and 2 cases were infect-ed by conventional compression hemostasis. During the follow-up period, 4 patients died, which occurred 3~30 months