冠状动脉旁路移植术后心房颤动的原因及防治  

THE CAUSES AND TREATMENT OF ATRIAL FIBRILLATION (AF) AFTER CORONARY ARTERY BYPASS GRATING

作　　者：王玺胜[1] 何学志[1] 智永超[1] 梁永才[1] 

机构地区：[1]辽宁省大连市中心医院心胸外科,116033

出　　处：《中国心血管病研究》2004年第4期260-262,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的讨论冠状动脉旁路移植术(CABG)后心房颤动(AF)的发生原因及防治方法。方法 对1998—2003年102例CABG术后患者(其中21例发生AF)进行回顾性研究分析。分析患者的临床资料,包括:年龄、性别、射血分数(EF)、左心房大小、心电图、心肌梗死情况、高血压病史、糖尿病史、搭桥支数、体外循环时间、升主动脉阻断时间、术前术后用药情况、AF患者的药物复律及电复律情况。结果 CABG术后AF发生率20.6％。应用胺碘酮后转复窦性心律10例,直流电复律3例,应用β受体阻滞剂后自动转复窦性心律3例,持续心房颤动3例,术后早期死于低心排血量2例。结论CABG术后AF的发生与多因素相关。围术期应用β受体阻滞剂、胺碘酮以及术中良好的心肌保护可降低术后心室率,减少AF的发生。术后应积极控制心室率,应用胺碘酮转律对CABG术后AF患者是较好的安全的手段。Objective To discuss the causes and treatment of atrial fibrillation after coronary artery bypass grafting. Methods To study the 102 cases with CABG(21 cases occurred AF after CABG) retrospectively and analyse the clinical data such as:age,sex,ejection fraction(EF) ,size of left atrium,ECG, myocardial infarction (MI), hypertension, diabetes mellitus, numbers of grafting, cardiopulmonary by-pass(CPB)time,aortic clamping time,using drug before and after operation. AF recovered sinus rhythm by using drugs or direct current. Results The incidence of AF after CABG is 20.6% . 10 cases recovered sinus rhythm after receiving amiodarone, 3 cases recovered sinus rhythm after direct current, 3 cases recovered sinus rhythm after receiving β blocker,3 cases keep lasting AF,2 cases died because low cardiac output. Conclusion The causes of AF after CABG correlate with multiple factors. Using β blocker,amiodarone and satisfactory myocardial preservation can decrease the ventricular rate and the occurrence of AF. After CABG, the ventricular rate should be controlled actively. Amiodarone is an effective and safe medicine to recover the AF after CABG to sinus rhythm.

关 键 词：冠状动脉旁路移植术 心房颤动 防治措施 AF CAGB 临床资料 手术治疗 

分 类 号：R654.2[医药卫生—外科学] R541.75[医药卫生—临床医学]