二尖瓣置换同期房颤射频消融的早期疗效分析  

Early analysis of the efficacy of radiofrequency ablation of atrial fibrillation over the same period of mitral valve replacement

作　　者：王柏春[1] 席振山 毕宏远[1] 樊占威 王浩然[2] 李悦[3] WANG Bai-chun;XI Zhen-shan;BI Hong-yuan;FAN Zhan-wei;WANG Hao-ran;LI Yue(Department of Cardiovascular Surgery, The Fourth Affiliated Hospital of Harbin Medical University ,Harbin 150001, China;Department of Cardiovascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, China;Department of Cardiovascular Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin 150001, China)

机构地区：[1]哈尔滨医科大学附属第四医院心外科,黑龙江哈尔滨150001 [2]哈尔滨医科大学附属第二医院心外科,黑龙江哈尔滨150081 [3]哈尔滨医科大学附属第一医院心内科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2019年第3期289-291,309,共4页Journal of Harbin Medical University

基　　金：黑龙江省教育厅科研项目(11511169)

摘　　要：目的研究二尖瓣置换同期行房颤射频消融术的疗效及其相关的影响因素。方法回顾性分析2015~2018年间收入我院二尖瓣病变合并房颤的患者70例为研究对象,在进行二尖瓣置换手术的同时,应用Atricure双极笔式射频消融装置进行房颤的射频消融术,收集患者围手术期的临床参数,随访3个月评价房颤的治疗效果,并根据术后是否转复为窦性心律分成2组,分别为转复组和未转复组,评价影响治疗效果的相关因素。结果在70例房颤患者中,术后3个月房颤转复为窦性心律的占75.7%,术后转复组与未转复组两组患者体外循环时间、术中出血量、术后引流量、呼吸机辅助时间、ICU时间比较无统计学差异(P>0.05)。两组患者不同房颤类型,术前EF值、左房大小、年龄,心功能级别比较有明显统计学差异(P<0.05)。结论二尖瓣置换同期房颤射频消融的早期效果良好,房颤的转复效果与患者的房颤类型、EF值、术前心功能、左房大小以及年龄相关。Objective To study the efficacy of radiofrequency ablation and mitral valve replacement for atrial fibrillation and related factors. Methods Retrospective analysis of 70 patients with mitral valve disease and atrial fibrillation who were admitted to our hospital during 2015~2018 were included radiofrequency ablation was performed for atrial fibrillation with Atricure bipolar pen radiofrequency ablation device while mitral valve replacement surgery, the clinical parameters of the perioperative period were collected, and the therapeutic effect of atrial fibrillation was evaluated after 3 months of follow-up, according to whether the sinus rhythm was converted, they were divided into two groups: the conversion group and the untransformed group, the influence factors were evaluated. Results Amog 70 cases of atrial fibrillation, the atrial fibrillation converted to sinus rhythm after 3 months was 75.7%, there was no significant difference in CPB time, intraoperative blood loss, postoperative drainage,ventilator assisted time and ICU time between the two groups(P>0.05). There were significant differences in preoperative EF values, left atrial size, age, and cardiac function between the two groups(P<0.05). Conclusion Mitral valve replacement has a good early effect of radiofrequency ablation for atrial fibrillation. The prognosis of atrial fibrillation is related to the type of atrial fibrillation, EF, preoperative cardiac function, left atrial size and age.

关 键 词：心房颤动 二尖瓣置换术 房颤射频消融 

分 类 号：R654.2[医药卫生—外科学]