冲洗式射频消融迷宫手术治疗不同病因永久性心房颤动的疗效比较  

Efficacy of saline-irrigated radiofrequency maze procedure for permanent atrial fibrillation

作　　者：黄晓华[1] 

机构地区：[1]武汉亚洲心脏病医院心外科,湖北武汉430022

出　　处：《心脏杂志》2014年第3期340-343,共4页Chinese Heart Journal

摘　　要：目的:分析和比较我院冲洗式射频消融迷宫手术治疗不同病因永久性心房颤动(房颤)的疗效。方法:收集我院2011年1月1日～2012年12月31日外科冲洗式射频消融迷宫手术治疗永久性房颤502例病例资料进行分析。根据病因(手术方式)不同分为两组:瓣膜置换并发冲洗式射频消融迷宫手术(瓣膜病组)406例;非瓣膜置换并发冲洗式射频消融迷宫手术(非瓣膜病组)96例。分别于术中心脏复跳、术后1周、3个月和6个月行超声心动图及心电图检查,观察左房、左室大小及窦性心律维持情况。结果:两组术后各时点心脏转复率均无显著差异,两组左房内径均较术前显著缩小。就全部患者而言,术中心脏转为窦性心律者为358例,转复率为71.3%;术后1周为376例,转复率为74.9%;术后3个月为347例,转复率为69.1%。术后6个月为339例,转复率为67.5%。总体手术死亡3例,2例死于低心排,1例死于恶性心律失常(室颤),手术死亡率为0.6%。结论:冲洗式射频消融迷宫手术治疗不同病因永久性房颤的疗效没有显著差异,疗效均较好。AIM To analyze the efficacy of saline-irrigated radiofrequency maze procedure for permanentatrial fibrillation （AF）. METHODS： Five hundred and two patients treated by saline-irrigated radiofre-quency maze procedure for permanent AF from January 1, 2011 to December 31, 2012 in our hospitalwere divided into two groups according to the different surgical procedures： 406 cases with valvularreplacement and 96 cases without valvular replacement during saline-irrigated radiofrequency maze proce-dure. Size of the left atrium, size of the left ventricle and maintenance of sinus rhythm were observed bycardio- and electrocardiogram examination in all patients during intraoperative cardiac resuscitation, and 1week, 3 months and 6 months after surgery. RESULTS： Three patients died. In two patients it was due tolow cardiac output syndrome and one patient died of malignant arrhythmia （ventricular fibrillation）.Three hundred and fifty-eight patients （71.3%） restored sinus rhythm during intraoperative cardiac re-suscitation, 376 cases （74.9%） restored sinus rhythm 1 week after surgery, 347 cases restored sinusrhythm （69.1%） 3 months after surgery and 339 cases restored sinus rhythm （69. 12% ） 6 months aftersurgery. CONCLUSION： Saline-irrigated radiofrequency maze procedure achieves good curative effectfor permanent AF.

关 键 词：射频消融迷宫手术 心房颤动 永久性 疗效 

分 类 号：R541.7[医药卫生—心血管疾病]