全胸腔镜下Box Lesion双极射频治疗心房颤动  

Video-assisted Thoracoscopic Box Lesion Bipolar Radiofrequency Ablation of Atrial Fibrillation

作　　者：石峻[1] 张本贵[1] 白志轩[1] 张尔永[1] 石应康[1] 郭应强[1] 

机构地区：[1]四川大学华西医院心血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2011年第5期433-435,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的探索一种新的全胸腔镜外科手术方法治疗单纯性心房颤动的疗效,以寻求更好的疗效、更小的创伤、更易于操作的微创手术方式。方法 2011年6月华西医院心血管外科在全胸腔镜下行Box Lesion双极射频(双侧肺静脉+左心房后壁隔离)治疗3例单纯性心房颤动患者,均为女性,年龄分别为40岁、60岁和66岁。手术在全胸腔镜下进行,在双侧胸壁肋间隙各行3个5～10mm的小切口;观察患者术后早期窦性心律的转复情况及并发症发生情况。结果 3例患者手术时间分别为140min、170min和155min,均在术后即刻转复为稳定窦性心律,术中平均失血量约80ml,术后住ICU 1d,术后平均住院7d,无手术死亡,无严重并发症。3例患者分别于术后1周、1个月复查心电图,均为窦性心律。结论本组手术初步显示Box Lesion双极射频心房颤动治疗术创伤小、术后恢复快,疗效满意,值得进一步研究、推广。Objective To explore a new video-assisted thoracoscopic surgical treatment for lone atrial fibrillation,in order to seek better efficacy,reduce invasiveness,and devise an easier-to-operate surgical treatment for atrial fibrillation.Methods In June 2011,3 women aged 40 years,60 years,and 66 years with lone atrial fibrillation were treated in the Cardiovascular Surgery Department of West China Hospital.The patients underwent a video-assisted thoracoscopic ＂Box Lesion＂ bipolar radiofrequency atrial fibrillation therapy（bilateral pulmonary vein ＋ left atrial posterior wall isolation）,including three 5 to 10 mm small incisions on each side of the chest wall.The complications and sinus rhythm maintenance of the patients were observed.Results The operative times were 140 min,170 min,and 155 min.The three patients were in sinus rhythm immediately after the surgery.Mean blood loss was approximately 80 ml,mean intensive care unit（ICU） stay was 1 day,and average hospital stay was 7 days.No deaths and serious complications occurred.The three patients were still in sinus rhythm one week and one month after the operation,as measured by electrocardiogram.Conclusion Box Lesion bipolar radiofrequency treatment for atrial fibrillation therapy shows fast postoperative recovery.It is a promising procedure in atrial fibrillation treatment and is worthy of further study

关 键 词：心房颤动 微创外科 BOX LESION 

分 类 号：R541.75[医药卫生—心血管疾病]