二尖瓣手术同期双心房与左心房心房颤动射频消融效果对比.docVIP

二尖瓣手术同期双心房与左心房心房颤动射频消融效果对比 　　【摘要】 目的：探究二尖瓣手术同期双极射频消融钳行左心房消融术与双心房消融术治疗房颤的效果和意义。方法：从2012年9月-2014年8月在本科二尖瓣手术同期实施双极射频消融钳Cox MazeⅣ手术的患者中随机选取128例作为研究对象。依据治疗方式的不同进行分组，其中58例左心房消融术组患者为对照组，70例双心房消融术组患者为观察组。两组患者在全麻状态且循环心脏停止跳动情况下实施左心房消融术与双心房消融术。观察两组患者的治疗效果。结果：观察组患者体外循环时间（121.52±13.15）min、主动脉阻断时间（72.61±6.25）min均明显长于对照组的（101.57±8.18）min、（61.54±4.83）min，差异均有统计学意义（P0.05）。结果表明，术前左房内径、房颤时长均为影响患者术后窦性心律恢复的危险因素（P0.05）。结论：二尖瓣病变伴房颤患者，实施双心房消融术可显著提高窦性心律维持率，减少心房扑动发生率，临床上也需对影响术后窦性心律恢复因素进行干预，从而提高临床疗效。 　　【关键词】 二尖瓣； 双极射频消融钳； 心房消融术； 心房颤动 　　【Abstract】 Objective：To investigate the effect and significance of left atrial ablation and biatrial ablation with bipolar radiofrequency ablation clamp for the treatment of atrial fibrillation in mitral valve surgery over the same period.Method：128 patients with bipolar radiofrequency ablation clamp for Cox Maze Ⅳ surgery in mitral valve surgery over the same period from September 2012 to August 2014 in our department were selected.According to the treatment methods，included 58 patients with left atrial ablation group as the control group，70 patients with biatrial ablation group as the observation group.The patients of two groups were given left atrial ablation and biatrial ablation respectively under general anesthesia state and implementation of cycle the heart stops beating.The treatment effects between the two groups were observed.Result：The extracorporeal circulation time and aorta blocking time of the observation group were （121.52±13.15）min and （72.61±6.25）min，which were significantly longer than （101.57±8.18）min and （61.54±4.83）min of the control group，the differences were statistically significant（P0.05）.The results showed that the preoperative left atrial diameter，AF duration were risk factors of postoperative sinus rhythm recovery in patients（P 　　【Key words】 Mitral valve； Bipolar radiofrequency ablation clamp； Atrial ablation； Atrial fibrillation 　　First-author’s address：Provincial Clinical College of Fujian Medical University，Fuzhou 350001