心房颤动患者左心耳切除与左心耳封堵的随访研究  

A follow-up study of left atrial appendage exclusion and left atrial appendage closure in patients with atrial fibrillation

作　　者：孙鹤 胡秋明[1] 孟旭[1] 韩杰[1] 李岩[1] SUN He;HU Qiuming;MENG Xu;HAN Jie;LI Yan(Department of Cardiac Surgery,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所心外科,100029

出　　处：《心肺血管病杂志》2018年第11期993-996,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:对比心房颤动患者内外科左心耳处理方式的远期疗效。方法:选取2010年1月至2017年6月,于我院分别行Wolf Mini-maze与左心耳封堵的患者46例,随访其术后服药情况及脑卒中发生情况。随访中位数时间为20. 5(2. 0,93)个月,最长时间为60个月。结果:两组经良好匹配,在基本资料、术前检查以及术后药物应用等,均差异无统计学意义。5年随访中免于脑卒中事件的比例为:外科95. 5%,内科75%(P=0. 013)。且左心耳处理费用方面外科显著低于内科。结论:外科左心耳切除比内科左心耳封堵更具有安全性且更为廉价。或将成为口服抗凝药的替代治疗方式。Objective:To compare the long-term efficacy between atrial appendage exclusion and left atrial appendage closure in atrial fibrillation patients.Methods:Patients who were treated with Wolf Mini-maze and left atrial appendage in our hospital from January2010to June2017were selected,and their postoperative medication and stroke were followed up.The median follow-up time was20.5(2.0,93)months and the maximum time was60months.Results:The two groups were well matched and there were no statistical differences in basic data,preoperative examination,and postoperative medication.The rate of stroke-free events at5-year follow-up was95.5%for exclusion and75%for closure(P=0.013).And left atrial appendage exclusion is quite cheaper than left atrial appendage closure.Conclusion:Surgical left atrial appendage exclusion is safer and less expensive than the left atrial appendage closure,and possibly can become an alternative treatment for oral anticoagulants.

关 键 词：心房颤动 左心耳 外科消融 

分 类 号：R54[医药卫生—心血管疾病]