双极射频消融术对心房颤动患者左心房结构和功能的影响  

Influence of left atrial structure and function by bipolar radio frequency current ablation in patients with atrial fibrillation

作　　者：李小庆[1] 胡建波[1] 唐红[2] 郭应强[3] 成力[1] 

机构地区：[1]第三军医大学新桥医院心内科,重庆400037 [2]四川大学华西医院心内科,四川成都610041 [3]四川大学华西医院胸心血管外科,四川成都610041

出　　处：《局解手术学杂志》2016年第2期108-112,共5页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的分析双极射频消融对心房颤动(房颤)患者左心房结构和功能的影响。方法四川大学华西医院2008年3月至2010年10月收治二尖瓣置换患者101例,将患者分为房颤射频消融组(43例),房颤拒绝射频消融组(30例)和非房颤组(28例),分别在手术前后进行经胸超声心动图检查。结果射频消融组左心房左右径变化率(24.24±8.67)%明显大于另外2组患者,差异具有统计学意义(P<0.05),左心房管道容积变化率(17.18±3.26)%,明显高于拒绝射频消融组(0.86±0.26)%,差异具有统计学意义(P<0.05),左心房总射血分数变化率(202.41±81.59)%,明显高于拒绝射频消融组(109.53±60.91)%,差异具有统计学意义(P<0.05),但左心房主动射血分数(12.18±3.48)%、总射血分数(41.31±8.26)%,均明显低于非房颤组的(21.33±5.61)%和(45.05±7.37)%,差异具有统计学意义(P<0.05),左心房后壁中间段和心底段应变变化率分别为(14.34±9.47)%和(13.20±8.38)%,明显低于其余节段,差异具有统计学意义(P<0.05)。结论双极射频消融后短期内患者左心房结构重构无明显改善,左心房管道功能代偿程度明显降低,左心房辅泵功能有明显改善,左心房后壁中间段及心底段舒缩功能改善程度相对较差。Objective To evaluate the changes of left atrial structure and function in the patients with atrial fibrillation who accepted bipolar radio frequency current ablation. Methods All patients in our study were divided into three groups including the ones who had accepted bipolar radio frequency current ablation because of atrial fibrillation,the ones who refused to accept ablation operation in despite of atrial fibrillation and the ones who maintained sinus rhythm before operation. All patients accepted TTE before and after operation. Results The rate of transverse diameter change of ablation group（ 24. 24 ± 8. 67） % was larger than those of other two groups（ P 〈 0. 05）. Left atrial channel capacity volume change rate of ablation group（ 17. 18 ± 3. 26） % were larger than the values of the group who were suffering atrial fibrillation but refused ablation advice（ 0. 86 ± 0. 26）（ P 〈 0. 05）. Left atrial total ejection fractions of ablation group（ 202. 41 ± 81. 59） % were larger than the values of the group who were suffering atrial fibrillation but refused ablation advice（ 109. 53 ± 60. 91） %（ P 〈 0. 05）. And its active ejection fractions（ 12. 18 ± 3. 48） %,total ejection fractions（ 41. 31 ± 8. 26） % and so forth were less than the group who maintained sinus rhythm before operation（ 21. 33 ± 5. 61） %,（ 45. 05 ± 7. 37） %,respectively（ P 〈 0. 05）. Left atrial posterior wall center and cardiac basal segment strain（ 14. 34 ± 9. 47） %,（ 13. 20 ± 8. 38） %,respectively,and strain rate values after operation of ablation group were less than other segments. Conclusion Left atrial structure remodeling inversion was not obviously 3 ~ 6 months after bipolar radio frequency current ablation. And at the same time,the improvement of left atrial storage function was not obviously compared with the group who refused ablation advice,left atrial channel function compensation degree descended obviously left atrial co-pumping function in ablation group increased

关 键 词：心房颤动 射频消融 超声心动描记术 左心房 

分 类 号：R541.75[医药卫生—心血管疾病]