【摘要】 目的总结永久性心脏起搏器治疗小儿缓慢性心律失常的经验。方法因症状性缓慢性心律失常在我院住院置入永久心脏起搏器的患儿30例,男19例、女11例,年龄6.8±4.1(1/12~15)岁。>10 kg的患儿全麻下穿刺左锁骨下静脉,放置心内膜起搏电极,起搏器置于左锁骨下皮下脂肪与肌肉间囊袋中;<10kg的婴儿放置心外膜电极,起搏器置于腹部固定于腹直肌。依据不同年龄将起搏频率设置为70~100次/m in(VVI/AAI/DDD),或60~70/130~140次/m in(VVIR/AAIR)。结果所有患儿均成功置入起搏器,无手术并发症发生,其中VVI 19例、VVIR 7例、AAI 2例、AAIR 1例、DDD 1例;经左锁骨下静脉放置心内膜电极27例,经腹部置入心外膜电极3例。术后随访3个月~6年,患儿体力均有明显改善,异常的左室内径和左室射血分数均于术后3个月内恢复正常。结论小儿起搏器治疗有效、安全,应根据患儿体重及全身状况选择适宜的起搏系统。更多还原

【Abstract】 Objective To investigate the efficacy and safety of permanent cardiac pacemaker implantation in children with bradyarrhythmia. Methods We studied 30 patients(19 men,1month~15 years) who had undergone pediatric pacemaker management.Under general anaesthesia,permanent cardiac pacemaker implantation was performed in the patients whose weight were>10 kg through left subclavian vein way.The atrial or ventricular leads were made a U-type curve in right atrium in order to fit children growth.Epicardial pacemakers were required in children who could not undergo a transvenous system because of small patient size (<10 kg).Electrocardiography,chest roentgenograms and echocardiography were examined at following-up. Results The success rate of pediatric pacemaker implantation was 100%.VVI 19,VVIR 7,AAI 2,AAIR 1,and DDD 1.There was no complication associated with the procedure.27 children underwent a transvenous system.3 cases had epicardial lead systems.Conclusions Pediatric pacemaker management for young patients with bradyarrhythmia is safe and effective.Our findings suggest that expanded utilization of transvenous systems in pediatric patients seems justified when anatomy permits.更多还原