刘晓宇,张常莹,郑杰,郁志明,王如兴.希氏束起搏与普通起搏术中患者射线暴露的比较[J].中华放射医学与防护杂志,2020,40(11):877-881
希氏束起搏与普通起搏术中患者射线暴露的比较
Comparison of fluoroscopy exposure between HIS bundle pacing and conventional pacing during procedures
投稿时间:2019-12-18  
DOI:10.3760/cma.j.issn.0254-5098.2020.11.012
中文关键词:  希氏束  起搏  心血管介入  剂量  患者
英文关键词:HIS Bundle  Pacing  Cardiovascular intervention  Dose  Patient
基金项目:
作者单位E-mail
刘晓宇 无锡市人民医院心血管内科 214023  
张常莹 无锡市人民医院心血管内科 214023  
郑杰 无锡市人民医院心血管内科 214023  
郁志明 无锡市人民医院心血管内科 214023  
王如兴 无锡市人民医院心血管内科 214023 ruxingw@aliyun.com 
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中文摘要:
      目的 比较希氏束起搏(HBS)和右心室心尖起搏射线暴露的差异。方法 回顾性记录无锡市人民医院2018年8月至2020年1月并分析30例希氏束起搏患者(HIS组)的手术总体及各阶段皮肤表面累积入射剂量(CD)和透视时间,并与同期右心室心尖植入心室电极的双腔起搏器(RVA)的32例患者(RVA组)对比。结果 HIS组和RVA组的手术操作时间为(76.8±13.1)和(66.0±10.8)min(t=3.386,P<0.001)、透视时间为(698.2±113.7)和(293.3±63.9)s(t=14.709,P<0.001)、透视剂量为(391.3±70.0)和(162.3±40.5)mGy(t=13.694,P<0.001);与右心室心尖电极植入过程相比,希氏束电极植入过程的透视时间[(501.2±112.3)和(103.4±30.6)s]及透视剂量[(279.9±65.0)和(57.3±13.8)mGy]明显增加(t=15.864,Z=-6.524,P<0.001)。结论 与右心室心尖起搏术相比,希氏束起搏手术时间更长,辐射剂量更大,需谨慎选择。
英文摘要:
      Objective To compare the differences of fluoroscopy time and dose between HIS bundle pacing and right ventricle apex pacing. Methods This study includes thirty patients undergoing HIS bundle pacing (HIS group) and 32 patients undergoing right ventricular apex pacing (RVA group). The fluoroscopy time and cumulative dose (CD) to patients during surgery were recorded and analyzed. Results The operation time for patients in HIS group and RVA group were (76.8±13.1) and (66.0±10.8) min (t=3.386, P<0.001), respectively. The fluoroscopy time was (698.2±113.7) and (293.3±63.9) s (t=14.709, P<0.001) and the CD were (391.3±70.0) and (162.3±40.5) mGy (t=13.694,P<0.001) in HBP group and RVA group, respectively. In comparison, the fluoroscopy time and CD for HIS bundle electrode implantation were (501.2±112.3) s and (279.9±65.0) mGy, respectively, significantly higher than in the case of RVA, where the values were (103.4±30.6) s and (57.3±13.8) mGy (t=15.864,Z=-6.524, P<0.001). Conclusions Compared with right ventricular apical pacing, the HIS bundle pacing takes longer operation time, leading to higher radiation dose, which should be prudently selected.
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