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目的:探讨42例室间隔缺损(VSD)封堵术前、后心电图的改变。方法:42例VSD患者在X线透视、经胸超声的监测下建立股动静脉轨道,经右心系统释放封堵器。对所有患者封堵术术前、术后即刻、3、7d、直至出院后1,2个月的12导联心电图作连续观察和分析。结果:42例患者术后即刻出现Ⅰ度房室传导阻滞(AVB)4例、Ⅱ度AVB1例、不完全性右束支传导阻滞(IRBBB)3例。3d出现IRBBB3例、完全性右束支传导阻滞(CRBBB)2例、Ⅰ度AVB4例、Ⅱ度AVB1例;术后7d出现IRBBB4例、CRBBB3例、出现左束支传导阻滞2例、Ⅲ度AVB2例。所有AVB经治疗后均痊愈。结论:VSD封堵术过程中可能会对房室传导产生一定影响。
Objective: To investigate the changes of electrocardiogram in 42 cases of ventricular septal defect (VSD) before and after closure. Methods: Forty-two patients with VSD underwent X-ray and transthoracic ultrasound to establish the femoral venous track. The occluder was released through the right heart. All patients were occluded before surgery, immediately after surgery, 3,7 d, 12 months after discharge and 12-lead ECG for continuous observation and analysis. Results: There were 4 patients with grade Ⅰ AVB, 2 patients with grade Ⅱ AVB and 3 patients with incomplete right bundle branch block (IRBBB) immediately after operation. There were 3 cases with IRBBB, 2 cases with complete right bundle branch block (CRBBB), 4 cases with Ⅰ degree AVB and 2 cases with AVB. The IRBBB was found in 7 cases and the CRBBB in 3 cases. There were 2 cases of left bundle branch block, AVB2 cases. All AVBs recovered after treatment. CONCLUSIONS: VSD occlusion may have some effect on atrioventricular conduction.