心内直视下射频消融治疗风湿性心脏病合并心房颤动的手术效果及对左心功能的影响  

Effect of Open-heart Radiofrequency Ablation on Rheumatic Heart Disease Complicated with Atrial Fibrillation and Its Influence on Cardiac Function

作　　者：黄杰 郑富臻[1] 鲍家银[1] 陈海宇[1] HUANG Jie;ZHENG Fuzhen;BAO Jiayin;CHEN Haiyu(Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院,福建福州350001

出　　处：《中外医学研究》2020年第30期49-51,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:分析心内直视下射频消融治疗风湿性心脏病(RHD)合并心房颤动的应用效果。方法:分析本院2016年1月-2017年12月收治的RHD合并房颤患者资料,均行心内直视下射频消融术及术后随访,结合手术及随访情况分析疗效。结果:转窦率术后即刻为98.75%,出院时为96.25%,术后1个月为96.25%,12个月为95.00%,24个月为93.13%,与治疗前差异有统计学意义(P<0.05)。左房内径出院时为(51.34±5.13)mm,治疗后12个月为(52.60±6.27)mm,治疗后24个月为(52.9±37.48)mm,与治疗前相比差异有统计学意义(P<0.05);左心室射血分数出院时为(58.13±6.40)%,治疗后12个月为(63.75±6.98)%,治疗后24个月为(65.35±5.98)%,与治疗前相比差异有统计学意义(P<0.05);体外循环时间(184.53±12.47)min,主动脉阻断时间(115.84±10.66)min,射频消融时间(26.35±4.69)min。ICU住院天数(2.12±0.36)d,总住院时间(15.35±2.35)d。并发症发生率1.22%。结论:给予RHD合并心房颤动患者心内直视下射频消融治疗效果显著,可改善患者左心功能,安全性高,推荐应用。Objective:To analyze the effect of open-heart radiofrequency ablation (RFA) in the treatment of rheumatic heart disease (RHD) complicated with atrial fibrillation.Method:The data of patients with RHD and atrial fibrillation who admitted to our hospital from January 2016 to December 2018 were analyzed.All patients underwent open-heart radiofrequency ablation and postoperative follow-up,surgery and follow-up were combined to analyze the efficacy.Result:The rate of sinus conversion was 98.75% immediately after operation,96.25% at discharge,96.25% at 1 month,95.00% at 12 months and 93.13% at 24 months after operation,and the difference was statistically significant (P<0.05).The left atrial diameter was (51.34±5.13) mm at discharge,(52.60±6.27) mm at 12 months after treatment and (52.9±37.48) mm at 24 months after treatment,the difference was statistically significant (P<0.05).Left ventricular ejection fraction at discharge was (58.13±6.40)%,12 months after treatment was (63.75±6.98)%,24 months after treatment was (65.35±5.98)%,which compared with before treatment,the difference was statistically significant (P<0.05).Cardiopulmonary bypass time (184.53±12.47) min,aortic clamping time (115.84±10.66) min,radiofrequency ablation time (26.35±4.69) min.The length of stay in ICU was (2.12±0.36) d and the total length of stay was (15.35±2.35) d.The incidence of complications was 1.22%.Conclusion:The efficacy of radiofrequency ablation in patients with RHD combined with atrial fibrillation is significant,which can improve the left cardiac function of patients and is of high safety.Therefore,it is recommended to use radiofrequency ablation.

关 键 词：心内直视 射频消融术 风湿性心脏病 心房颤动 手术疗效 左心功能 

分 类 号：R654.2[医药卫生—外科学]