二尖瓣替换术后房颤转复为窦性心律的临床分析  

Clinical Analysis of Conversion of Atrial Fibrillation after Mitral Valve Replacement

作　　者：侯晓彤[1] 孙衍庆[1] 李潮[1] 周其文[1] 

机构地区：[1]首都医科大学附属北京安贞医院,100029

出　　处：《心肺血管病杂志》1997年第2期124-126,共3页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：在风湿性心脏病二尖瓣病变中，慢性心房纤颤（简称房颤）是一种常见的并发症。房颤会给病人带来许多问题，如左房血栓形成、体循环栓塞、心房扩大和心输出量减少等并发症，从而增加了死亡率，影响了生活质量的提高。因此，人们一直采用各种方法使之转复为窦性心律。风湿性心脏病二尖瓣替换术同时给予电除颤，可使部分病人恢复窦性心律。本组对89例患风湿性心脏病二尖瓣替换术后房颤转复情况进行了回顾性研究，根据手术后病人出院时的心律情况将病人分为两组，A组为出院时仍为房颤者，B组为出院时为窦性心律者。分析结果表明，风湿性心脏病二尖瓣替换术后，解除了机械梗阻，部分术前伴有房颤的病人术后可以转复为窦性心律，但能维持至1个月以上者较少，仅占手术病人的15．7％。病人手术时的年龄、房颤病史长短及左房径对房颤转复情况有显著影响，且可以预见其短期效果，根据本组病例分析的结果表明，年龄小于40岁、房颤病史不超过一年、左房径小于55mm的病人，窦性心律可维持在1个月以上。Chronic atrial fibrillation (AF) is a common arrhythmia in patients with rheumatic valvular disease.It accounts for increased morbidity and mortality because of its associated risk of thromboembolism and its impact on cardiac function. Various methods have been taken to convert AF to sinus rhythm (SR). In some some patients, SR can be regainal after whiral valve replacement. In this retrospective study we included 89 patients with AF before the operation. 57 patients (64. 1 % ) regained SR after operation, only 14 patients (15. 7% ) maintained SR at the time of discharge. It appears duration of AF, age at the time of operation and left atrial diameter do pedict maintenance of SR 1 month after the initial success. This analysis shows that SR can be maintained more than 1 month in patients wade age ≤40 years, duration of AF ≤1 year and left atrial diameter ≤ 55 mm.

关 键 词：二尖瓣替换术 心房纤颤 手术后 窦性心律 

分 类 号：R654.2[医药卫生—外科学]