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目的分析全军导管消融治疗心律失常并发症产生的原因,进一步减少或避免并发症的发生,降低手术风险,提高安全性。方法纳入2010年1月1日至2014年12月31日互联网注册登记的85家医院共36 768例患者,各单位由专人详细登记并上报每例患者的术前诊断、电生理诊断、导管消融结果及术中并发症等情况。由全军心血管内科专业委员会质控委员会下属的质控中心负责资料汇总和统计分析。结果 (1)共123例(0.33%,123/36 768)患者发生并发症;(2)并发症主要为心脏压塞49例(39.8%,49/123)和完全性房室传导阻滞35例(28.5%,35/123),其余为严重迷走神经反射、恶性高热和急性幽门梗阻伴胃扩张等。结论全军导管消融治疗心律失常工作发展迅速。围术期应做好充分准备,出现罕见并发症应及时做出判断,总结经验,不断提高手术安全性。
Objective To analyze the causes of the complications of catheter ablation in the treatment of arrhythmia, further reduce or avoid the complication, reduce the operation risk and improve the safety. METHODS: A total of 36 768 patients were enrolled in 85 hospitals registered on the Internet from January 1, 2010 to December 31, 2014. All units were registered by specialists and reported to each patient for preoperative diagnosis, electrophysiological diagnosis, catheter ablation Results and intraoperative complications and so on. The quality control center under the control committee of the Cardiovascular Internal Medicine Professional Committee is responsible for data collection and statistical analysis. Results (1) A total of 123 patients (0.33%, 123/36 768) had complications. (2) Complications were mainly caused by 49 cases (39.8%, 49/123) of cardiac tamponade and complete atrioventricular block Cases (28.5%, 35/123), the rest were severe vagal reflex, malignant hyperthermia and acute pyloric obstruction with gastric distension. Conclusion The whole army catheter ablation treatment of arrhythmia work is developing rapidly. Perioperative period should be fully prepared, the emergence of rare complications should make timely judgments, sum up experience and continuously improve the safety of surgery.