心房颤动射频消融术后复发的分阶段诊疗思路  

Phased Diagnosis and Treatment of Recurrence after Radiofrequency Ablation of Atrial Fibrillation

作　　者：时娜 杨建飞[2] 王贺[2] 周亚滨[2] Shi Na;Yang Jianfei;Wang He;Zhou Yabin(Heilongjiang University of Chinese Medicine,Heilongjiang,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040

出　　处：《中国中医急症》2024年第9期1566-1568,1585,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：本文认为,心房颤动射频消融术后近期复发患者多以“瘀结正虚”为特点,术后远期复发患者多以“瘀与邪结”为特点。故治疗时应重视辨析术后病机的动态演变,抓病机本质,针对术后近期与远期的病机特点,分阶段辨证论治。在术后近期应化瘀与补虚并重,予益气活血、养心安神之法;术后远期应重点关注瘀血与气滞、痰浊、火邪、水饮等实性病邪,将活血化瘀贯穿治疗全程,分别予以理气、豁痰、降火和化饮之法,并关注患者的基础疾病、生活方式和精神心理,从多方位防治射频消融术后房颤复发。This article believes that patients with recent recurrence after radiofrequency ablation of atrial fibrillation are mostly characterized by"stasis and deficiency",and patients with long-term recurrence after surgery are mostly characterized by"stasis mixed with evil".Therefore,the treatment should pay attention to the dynamic evolution of the pathogenesis after operation,grasp the essence of the pathogenesis,and treat the disease in stages according to the characteristics of the pathogenesis in the short and long term after operation.In the early postoperative period,equal emphasis should be placed on resolving stasis and replenishing qi,employing methods such as qi-nourishing and blood-activating,and nourishing the heart to calm the spirit.In the late postoperative period,attention should be focused on blood stasis combined with qi stagnation,phlegm turbidity,fire pathogen,and fluid retention,with blood-activating and stasis-resolving methods being applied throughout the treatment course,along with qi-regulating,phlegm-dispersing,fire-reducing,and fluid-transforming methods.Additionally,attention should be paid to the patient′s underlying diseases,lifestyle,and mental state,adopting a multidimensional approach to prevent and treat recurrence of AF after RFA.

关 键 词：心房颤动 射频消融术 分阶段诊疗 

分 类 号：R541.45[医药卫生—心血管疾病]