瓣膜置换同期行射频消融治疗房颤的围手术期管理及随访  

The management and follow-up of radiofrequency-ablation in valve-replacement for treating atrial fibrillation

作　　者：邬晓臣[1] 张近宝[1] 欧阳辉[1] 岳琴[1] 辛梅[1] 丁盛[1] 辛东[1] 刘小燕[1] 张宇兵[1] 

机构地区：[1]成都军区总医院心血管外科,成都610083

出　　处：《北京医学》2013年第7期506-508,共3页Beijing Medical Journal

基　　金：成都军区十二五课题(C12039)

摘　　要：目的总结心脏瓣膜置换术同期行双极射频消融治疗心房纤颤的临床效果。方法将2010年1月至2012年10月收治的120例风湿性瓣膜病变合并心房纤颤的患者,分为射频消融组(60例,在进行瓣膜置换术中同期行射频消融术)和单纯换瓣组(60例,单纯行瓣膜置换术)。结果两组患者年龄、房颤病史、左房内径、左室射血分数、体外循环时间和主动脉阻闭时间等参数差异均无统计学意义。射频消融组和单纯换瓣组在术毕和随访1年时房颤转复率比较差异均有统计学意义(75%vs.18%;70%vs.10%;P﹤0.05)。1年后复查心脏超声提示,射频消融组内转复为窦性心律的患者较未转复者左房内径更小[(47.3±5.6)mmvs.(49.1±6.1)mm],但差异无统计学意义(P=0.271),这可能与样本小有关。单纯换瓣组转复为窦性心律患者的左房内径与未转复者比较差异亦无统计学意义[(47.9±6.4)mmvs.(49.0±6.9)mm,P>0.05)]。结论二尖瓣膜置换术中同期行射频消融治疗心房纤颤是一种较安全、有效的治疗方法。Objective To investigate the clinical management and follow-up of radiofrequency ablation in valve-replacement for treating patients of rheumatic heart disease complicated with atrial fibrillation.Methods One hundred and twenty rheumatic heart disease（RHD） patients with AF admitted to the hospital for valve replacement operation from January 2010 to October 2012 and were divided into two groups based on their acceptance of radiofrequency ablation（RFB） or not.The experimental group（Group A） included 60 cases who accepted RFB during valve replacement surgery and other 60 cases refused RFB made up the control group（Group B）.Results The clinical characteristics of the two groups like age,history of AF,LAD,time of aorta block,time of CPB did not show significant difference.And the rate of sinus rhythm between these two groups at the end of operation and 1 year after operation differed significantly.LAD at 1 year after operation between patients with sinus rhythm and AF did not show significant difference.Conclusion It may be an effective method to treat AF with radiofrequency ablation in valve-replacement surgery.

关 键 词：瓣膜置换手术 射频消融 心房颤动 

分 类 号：R654.2[医药卫生—外科学]