胎儿完全性房室传导阻滞宫内经静脉心脏起搏治疗的研究Intrauterine Transvenous Cardiac Pacing for Fetal Complete Heart Block
刘春峰,菊池酆,白石裕比湖,柳沢正羲
摘要(Abstract):
为探讨胎儿完全房室传导阻滞宫内起搏治疗的可能性,本文采用6例羊胎作为研究对象,通过开腹剖宫的方式,对羊胎实行了经静脉右心室心内膜起搏,测定了三种情况下右心室输出量并对三尖瓣关闭不全的程度作了半定量测定,6例羊胎经静脉起搏电极的插入均顺利完成,右心室输出量测定结果如下:起搏电极前端留置在上腔静脉时(基准值):107.0±13.3ml·kg-1·min;起搏电极前端经三尖瓣插入右心室后,右心输出量减少到73.8±175ml·kg-1·min(P<0.05);以200/分的频率右心室起搏后,右心输出量为78.3±23.6ml·kg-1·min;三尖瓣反流的半定量测定(三尖瓣反流信号/右房面积):起搏电极前端在上腔静脉留置时(基准值),三尖辩反流信号右房之比为0.13±0.047;起搏电极前端经三尖瓣插入右室后为0.16±0.089;以200/分频率右心室起搏时,该比值为0.16±0.089。三种情况下,三尖瓣反流的程度无明显差别(P>0.05)。本文结果表明,通过手术的方式给胎儿安植心脏起搏器是完全可行的。
关键词(KeyWords): 羊胎;经静脉心脏起搏;完全房室传导阻滞;三尖瓣反流
基金项目(Foundation):
作者(Author): 刘春峰,菊池酆,白石裕比湖,柳沢正羲
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