心房颤动的手术治疗  

Evaluationofthecardiacperformanceaftermazeprocedureinchronicatrialfibrilation

作　　者：李莉[1] 王尔松[1] 汪曾炜[1] 张宝仁[1] 朱家麟[1] 郝家骅[1] 徐志云[1] 王志农[1] 

机构地区：[1]第二军医大学长海医院胸心外科

出　　处：《中华心血管病杂志》1996年第6期416-420,共5页Chinese Journal of Cardiology

摘　　要：心房颤动的手术治疗心房颤动（房颤）的理想手术治疗应达到以下三个目的：（１）消除房颤恢复窦性心律；（２）重建和（或）维持房室同步活动；（３）恢复两心房传输功能，从而消除单房或双房的血流瘀滞以减低或消除血栓栓塞的危险。迄今为止，所有的非直视手术介入方法均...MultidimensionalmethodsofanalysisbeyondstandardmeasurementofthesizeandthevolumewereundertakenbyusingM-modeand2-dimensionalechocardiogramstoevaluatechangesinleftatrium(LA)functionandeffectsofmazeprocedureoncardiacperformancein14rheumaticheartdisease(RHD)patientswithchronicatrialfibrilationand12healthypersons.LAstrokevolumeinRHDgroupwassignificantlygreaterinperioperativeperiodthanthenormal(25.14±7.88cm3vs18.69±3.56cm3,P<0.05).LAactiveemptyingvolumewasnotsignificantlydiffer-entinperioperationand3monthspost-operativelycomparedwiththehealthygroup.LApassiveemptyingvolumewashigherthanthatofthehealthygroupinperioperativeperiodand3monthsafteroperation(8.58±2.74cm3and11.54±5.69cm3vs5.93±1.66cm3,P<0.05).LAejectionfrac-tionswerelowerthanthoseofthehealthygroup.LAkineticenergy(LAKE)wasgreaterinperioper-ativeperiodthanthatofthehealthygroup,andwasnotdiferent3monthsafteroperation.Theintraoperativetransesophagealechocardiograms(TEE)werestudiedusingtheDopplerflowvelocityspectraacrossthemitralvalveandthetricuspidvalveimmediatelyafterthemazeprocedureTEEdocumentedthe100%presenceofLAandRAcontractionfunction3monthsafteroperation.Thepost-operativeLVperformanceshowedthatLVDd,LVDs,LVEDVandLVESValim-provedsignificantlythanthoseinpreoperativeperiod,andhadnodifferencecomparedwiththehealthygroup3monthsafteroperation.

关 键 词：风湿性心脏病 心房颤动 迷宫手术 心功能 

分 类 号：R541.206[医药卫生—心血管疾病] R541.750.2[医药卫生—内科学]