三维标测减少AVNRT射频消融术中术者X线受照剂量的研究  

Study on the three-dimensional mapping to reduce the X-ray exposure dose of intervenfional doctors in radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia

作　　者：王睿[1] 张楠[1] 王瑞华[1] 高佳[1] 赵志强[1] 贾永平[1] 孙萌[1] Wang Rui Zhang Nan Wang Ruihua Gao Jia Zhao Zhiqiang Jia Yongping Sun Meng.(The First Hospital of Shanxi Medical University, Taiyuan 030001, China)

机构地区：[1]山西医科大学第一医院心内科,太原030001

出　　处：《中华劳动卫生职业病杂志》2017年第8期614-616,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

摘　　要：目的探究三维标测下射频消融治疗房室结折返性心动过速（AVNRT）在减少术者X线受照剂量上的优势。方法于2015年1月至2016年6月，选取79例拟行射频消融治疗的AVNRT患者，按随机数字法分入二维标测组（39例）与三维标测组（40例）。二维标测组在x线透视下标测消融靶点，三维标测组利用CARTO3系统标测消融靶点。比较术中X线透视时间、手术成功率、并发症发生率以及术者X线受照剂量。结果与二维标测组相比，三维标测组患者即刻消融成功率及并发症发生率差异无统计学意义（P〉0．05）；与二维标测组相比，三维标测组消融过程X线透视时间及术者X线受照剂量明显减少，差异有统计学意义（P〈0．05）。结论三维标测下射频消融治疗AVNRT能减少患者及医务人员X线照射时间以及术者x线受照剂量，降低电离辐射对人体的潜在危害。Objective To explore the advantage of radiofrequeney catheter ablation under the three- dimensional mapping in the treatment of atrioventricular nodal reentrant tachycardia（AVNRT） in reducing the X-ray exposure dose of interventional doctors. Methods 79 patients with AVNRT, in the first hospital of Shanxi Medical University from January 2015 to June 2016, performed to do radiofrequency catheter ablation treatment were selected, and according to the random number method were divided into two-dimensional mapping group and three- dimensional mapping group. The two-dimensional mapping group was mapped the ablation target at the X-ray, while the ablation target was mapped by CARTO 3 system in the three-dimensional mapping group. Compare the X-ray fluoroscopy time, success rate, complications rate and doctor＇s X-ray exposure dose between the two groups. Results Compared with the two-dimensional mapping group, acute success rate and complication rate of the three dimensional mapping group were not statistically significant （P〉0.05）, while the X-ray fluoroscopy time and the X- ray dose of the three-dimensional mapping group decreased significantly, the difference was statistically significant （P〈0.05）. Conclusion Three-dimensional mapping can significantly reduce the X-ray irradiation time and interventional doctor＇ s X-ray exposure dose in radiofrequency catheter ablation of AVNRT patients and the potential hazards of ionizing radiation on the human body.

关 键 词：三维标测 射频消融 辐射 电离 心动过速 房室结折返性 

分 类 号：R541.7[医药卫生—心血管疾病]