【摘要】 目的:探讨小脑顶核电刺激(Fastigial nucleus stimulation,FNS)治疗非恶性心律失常(Nonmalignant cardiac arrhythmia)的疗效及安全性。方法:随机选择一段时期,对反复心悸为主诉就诊的病人,进行24h动态心电图检查有心律失常(室上性早搏、短阵室上性心动过速、室性早搏),且曾给予一种或几种抗心律失常药物治疗病情无好转者45例,用小脑顶核电刺激治疗,每次治疗40min,每周2次,每位患者治疗15次左右。观察24h动态心电图等变化。结果:FNS治疗前后室上性早搏数分别为(3358.5±5044.0)次/24h和(1142.8±2722.3)次/24h,室性早搏数为(10469.7±9464.9)次/24h和(4379.4±8143.3)次/24h,标准化的低频(Normalized low frequency,LFnorm)为(35.28±7.04)nU和(31.82±7.35)nU,标准化的高频(Normalized high frequency,HFnorm)为(24.32±4.18)nU和(26.84±4.66)nU,LF/HF为1.47±0.32和1.21±0.29,以上差异均有统计学意义(P<0.05);FNS治疗室上性早搏和室性早搏的有效率分别为64.44%和63.89%;治疗后短阵室上性心动过速评分较治疗前明显降低,差异具有统计学意义(P<0.05);未发现不良反应。结论:FNS治疗对心律失常患者心脏自主神经功能失调有改善作用;FNS治疗可明显减少室上性早搏、室性早搏的发生;FNS是一种安全、有效、价廉和易于操作的治疗手段,值得进一步的研究和推广。更多还原

【Abstract】 Objective:To study the curative effect and reliability of fastigial nucleus stimulation (FNS)in treating nonmalignant arrhythmia. Methods:In a random period,FNS was used to treat 45 patients,who consulted doctors for repetitive palpitation,had cardiac arrhythmia (supraventricular premature beats,supraventricular runs,ventricular premature beats)confirmed by 24 h Holter monitoring electrocardiogram,and whose state of illness did not improve after being treated by one or several antiarrhythmic drugs. After those patients were treated by FNS 40 minutes a time,two times a week,for 15 times,the changes of 24 h Holter monitoring electrocardiogram were observed. Results:Before and after treatment by FNS,the numbers of SVPB were (3 358.5±5 044.0)/24 h and (1 142.8±2 722.3)/24 h respectively;those ofVPBwere(10 469.7±9 464.9)/24 h and(4 379.4±8 143.3)/24 h respectively;normalized low frequencies(LFnorm)were(35.28±7.04)nU and(31.82±7.35)nU respectively;normalized high frequencies(HFnorm)were (24.32±4.18)nU and (26.84±4.66)nU respectively. LF/HF was 1.47±0.32 and 1.21±0.29 respectively. The differences between pre-treatment and post-treatment indices were all statistically significant (P<0.05). Effective rates of SVPB and VPB by FNS were 64.44% and 63.89% respectively. Supraventricular runs paroxysm markedly decreased after treatment (P<0.05). FNS did not cause adverse reaction. Conclusion:FNS can significantly decrease SVPB and VPB. FNS can improve cardiac autonomic nervous dysfunction in the patients with cardiac arrhythmia. FNS is a therapeutic tool which is safe,effective,easy to be operated and affordable,and it is worth researching and spreading further.更多还原