经冷冻球囊导管消融与射频消融在阵发性房颤治疗中的疗效对比  

Comparative Analysis of Frozen Balloon Ablation and Radiofrequency Ablation for Paroxysmal Atrial Fibrillation:a Single Center Randomized Controlled Study

作　　者：沈祥礼 马骏 李岚 孙龙飞 何义 刘旭正 姜述斌 王金晶 SHEN Xiang-li;MA Jun;LI Lan;SUN Long-fei;HE Yi;LIU Xu-zheng;JIANG Shu-bin;WANG Jin-jing(Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine,Xinjiang Urumqi 830000)

机构地区：[1]新疆维吾尔自治区中医医院,新疆乌鲁木齐830000

出　　处：《中国医疗器械信息》2024年第11期138-141,共4页China Medical Device Information

基　　金：新疆维吾尔自治区中医医院院级课题(课题名称:探讨“金三角”治疗对房颤冷冻消融患者左心房内径及房颤复发率的影响,课题编号:ZYY201920)。

摘　　要：目的:经冷冻球囊导管消融和射频消融治疗阵发性房颤临床疗效对比分析。方法:将2018年10月~2022年6月新疆维吾尔自治区中医医院收治的阵发性心房颤动患者208例作为观察对象,按消融方式随机分组,观察组104例,实施经冷冻球囊导管消融治疗;对照组104例,实施射频消融治疗。比较两组的即刻成功率、1年复发率、手术时间、X射线曝光剂量及并发症(包括血管穿刺并发症、膈神经损伤、血栓栓塞、心脏压塞、心房食道瘘、死亡等)发生情况。结果:两组患者治疗前的年龄、性别、左心房大小、房颤病史,合并疾病(高血压、糖尿病、心力衰竭)均无统计学意义(P>0.05);观察组与对照组即刻成功率相当(98%,97%,P>0.05);观察组与对照组比较,1年后房颤复发率差异有显著性意义(10.6%,19.2%,P<0.05);手术时间(108.4±18.5)min短于对照组(148.6±18.7)min,P<0.005,观察组X射线透视时间(20.5±4.6)min略长于对照组(17.9±4.8)min,P<0.005。观察组血管穿刺并发症5例,对照组4例,无统计学差异(P>0.05),观察组出现膈神经损伤2例,均术中即刻恢复,两组均无血栓栓塞、心脏压塞、心房食道漏、死亡等严重并发症。结论:在阵发性房颤治疗中,经冷冻球囊导管消融即刻成功率与射频消融相当,手术并发症差异小;与射频消融相比,经冷冻球囊导管消融X射线透视时间略长,但具有手术时间短、患者较为舒适,一年复发率低的优势。Objective:Comparative analysis of clinical efficacy of cryoballoon catheter ablation and radiofrequency ablation in the treatment of paroxysmal atrial fibrillation.Methods:A total of 208 patients with paroxysmal atrial fibrillation admitted to the Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine from October 2018 to June 2022 were selected as the observation objects.They were randomly divided according to the ablation method,and 104 patients in the observation group were treated by cryoballoon catheter ablation.Control group 104 patients were treated with radiofrequency ablation.The immediate success rate,1-year recurrence rate,operation time,X-ray exposure dose and the occurrence of complications(including vascular puncture complications,phreatic nerve injury,thromboembolism,pericardial tamponade,atrial esophageal fistula,death,etc.)were compared between the two groups.Results:There was no statistical significance in age,sex,left atrial size,history of atrial fibrillation,and complicated diseases(hypertension,diabetes,heart failure)before treatment in 2 groups(P>0.05).The immediate success rate of observation group and control group was similar(98%,97%,P>0.05).The recurrence rate of atrial fibrillation after 1 year was significantly different between the observation group and the control group(10.6%,19.2%,P<0.05).The operation time(108.4±18.5)min was shorter than that of the control group(148.6±18.7)min,P<0.005;The X-ray fluoroscopy time(20.5±4.6)min in the observation group was slightly longer than that of the control group(17.9±4.8)min,P<0.005.There were 5 cases of vascular puncture complications in the observation group and 4 cases in the control group,with no statistical difference(P>0.05).There were 2 cases of phrenic nerve injury in the observation group,all of which recovered immediately during the operation.There were no serious complications such as thromboembolism,pericardial tamponade,atrial esophageal leakage,and death in both groups.Conclusion:In the treatment of paroxys

关 键 词：心房颤动 冷冻球囊 射频消融 

分 类 号：TH778[机械工程—仪器科学与技术]