房颤双极射频消融术在二尖瓣机械瓣膜置换患者中的应用效果分析  

Application Effect of Atrial Fibrillation Bipolar Radiofrequency Ablation in Patients Undergoing Mitral Valve Mechanical Valve Replacement

作　　者：白上林[1] 佘凯[1] 熊伟[1] 朱春艳 Bai Shanglin;She Kai;Xiong Wei;Zhu Chunyan(Department of Cardiac Surgery, Sichuan Mianyang 404 Hospital, Mianyang 621000, China)

机构地区：[1]四川绵阳四0四医院心脏外科,绵阳621000

出　　处：《成都医学院学报》2022年第3期329-332,共4页Journal of Chengdu Medical College

基　　金：四川省卫生健康委员会普及应用项目(No:16PJ377)。

摘　　要：目的分析房颤双极射频消融术在二尖瓣机械瓣膜置换患者中的应用效果。方法回顾性分析2015年10月至2020年10月绵阳四0四医院收治的108例二尖瓣机械瓣膜置换患者的临床资料,根据是否行房颤双极射频消融术分为射频消融组(二尖瓣机械瓣膜置换同期行房颤双极射频消融术)60例和二尖瓣置换组(单纯二尖瓣机械瓣膜置换术)48例,随访半年,比较两组患者体循环时间、主动脉阻断时间、ICU停留时间和住院时间,以及不同时间(术前和术后1、3、6个月)的左室射血分数(LVEF)、左室舒张末内径(LVD)和窦性心律恢复情况,记录两组不良事件发生率。结果二尖瓣置换组体循环时间、主动脉阻断时间均短于射频消融组(P<0.05);术后3、6个月射频消融组LVEF水平高于二尖瓣置换组,LVD水平低于二尖瓣置换组,差异有统计学意义(P<0.05);术后不同时间射频消融组窦性心律恢复情况均优于二尖瓣置换组(P<0.05);两组不良事件发生率比较,差异无统计学意义(P>0.05)。结论二尖瓣机械瓣膜置换患者同期行房颤双极射频消融术,能提高患者心功能,窦性心律转复情况好,不良事件发生率低。Objective To analyze the application effect of atrial fibrillation bipolar radiofrequency ablation in patients undergoing mitral valve replacement with mechanical valve.Methods A retrospective analysis was performed on the 108 patients undergoing mitral valve mechanical valve replacement in Sichuan Mianyang 404 Hospital between October 2015 and October 2020.According to presence or absence of atrial fibrillation bipolar radiofrequency ablation,the patients were divided into radiofrequency ablation group(n=60,mitral valve mechanical valve replacement combined with atrial fibrillation bipolar radiofrequency ablation)and mitral valve replacement group(n=48,simple mitral valve mechanical valve replacement).All were followed up for half a year.The systemic circulation time,aortic occlusion time,length of ICU stay and hospital stay,left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVD)and sinus rhythm recovery at different time points(before surgery,1,3 and 6 months after surgery)were compared between the two groups.The incidence of adverse events in both groups was recorded.Results The systemic circulation time and aortic occlusion time in mitral valve replacement group were shorter than those in radiofrequency ablation group(P<0.05).At 3 and 6 months after surgery,radiofrequency ablation group had higher LVEF and shorter LVD compared with mitral valve replacement group,and the differences were statistically significant(P<0.05).The sinus rhythm recovery at different time points in radiofrequency ablation group was better than that in mitral valve replacement group(P<0.05).The difference in the incidence of adverse events between the two groups was not statistically significant(P>0.05).Conclusion Atrial fibrillation bipolar radiofrequency ablation can effectively improve cardiac function in patients undergoing mitral valve mechanical valve replacement,with good sinus rhythm recovery and few adverse events.

关 键 词：二尖瓣机械瓣膜置换 房颤双极射频消融 心房纤颤 心功能 窦性心律 

分 类 号：R541[医药卫生—心血管疾病]