经胸阻抗与心房快速性心律失常的电复律成功的相关性分析

摘要

目的:探讨经胸阻抗在心房快速性心律失常患者电复律中的应用效果及与成功率的相关性.方法:选取2016年5月-2018年3月入院治疗的心房快速性心律失常患者68例,均采用电复律治疗,治疗过程中采用经胸阻抗对患者进行动态监测.比较患者治疗前后的左室射血分数(LVEF)、血管阻力(SVR)、左心室舒张末容积(LVEDV)及左心室收缩末容积(LVESV)等心功能水平,分析经胸阻抗监测结果与患者电复律成功率、心功能水平的相关性.结果:患者均经过电复律治疗,63例1次同步直流电复律后恢复,未见明显并发症,2例由于多次电复律皮肤出现轻微的灼伤,2例电复律后转复为窦性,随后出现心率复发,1例治疗后出血肺水肿,经抢救后无效,死亡,经胸阻抗监测治疗过程中出现78例报警;治疗后LVEF水平高于治疗前,SVR、LVEDV及LVESV水平均低于治疗前,比较差异均有统计学意义(P<0.05);相关性分析显示,患者经胸阻抗监测结果与成功率、LVEF水平均呈正相关性(P<0.05),与SVR、LVEDV及LVESV水平均呈负相关性(P<0.05).结论:经胸阻抗用于心房快速性心律失常患者中能获得较高的抢救成功率,且与心功能水平具有一定的相关性.%Objective:To investigate the effect of transthoracic impedance on electrocardiogram in patients with atrial tachyarrhythmia and its correlation with success rate.Method:A total of 68 patients with atrial tachyarrhythmia who were admitted to hospital from May 2016 to March 2018 were selected,they were treated with electrical conversion,and during the treatment,transthoracic impedance was used to monitor the patients. The left ventricular ejection fraction(LVEF),vascular resistance (SVR),left ventricular end-diastolic volume (LVEDV) and left ventricular end-systolic volume(LVESV) were compared before and after treatment,and the correlation between the results of transthoracic impedance monitoring and the success rate of electrical conversion and the level of cardiac function were analyzed.Result:All patients were treated with electrical conversion,and 63 patients recovered after 1 synchronous DC cardioversion,no obvious complications were found,2 cases had mild burns due to multiple electrical cardioversion,2 cases turned to sinus after electrical cardioversion,followed by heart rate recurrences,1 case of hemorrhagic pulmonary edema after treatment was ineffective after rescue, and died.78 cases were alarmed during the treatment by thoracic impedance monitoring.After treatment,the level of LVEF was higher than that of before treatment,and the SVR,LVEDV and LVESV levels were lower than those of before treatment,the differences were statistically significant(P<0.05).Correlation analysis showed that there was a positive correlation between the results of transthoracic impedance monitoring and the success rate and LVEF level(P<0.05),and a negative correlation with SVR,LVEDV and LVESV levels(P<0.05). Conclusion:Transthoracic impedance can be used in patients with atrial tachyarrhythmia to achieve a higher rescue success rate,and has a certain correlation with cardiac function.