心脏瓣膜置换同期行双极射频消融术治疗心房纤颤.pdf

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1、生!旦第42卷期ChineseJournalofPracticalMedicineJuly2015，Vo1．42．No．14·31·心脏瓣膜置换同期行双极射频消融术治疗心房纤颤陈红卫潘砚鹏陈文宽詹海波陈刚【摘要】目的探讨瓣膜置换术同期双极射频消融(改良Mazem手术)治疗房颤(AF)的临床疗效。方法将2010年10月至2012年9月郑州市第七人民医院收治的56例风湿性心脏瓣膜病合并房颤患者分为两组，观察组瓣膜手术同期行双极射频消融术治疗房颤，对照组仅行瓣膜置换而不进行房颤外科治疗，比较两组疗效。结果

2、两组病死率比较差异未见统计学意义，观察组未发生双极射频消融术相关并发症。观察组术后当日、1周、1个月、3个月、1年的房颤转复率分别为94．1％、88．2％、84．3％、78．9％、76．2％，明显高于对照组的22．7％、5．68％、5．51％、5．64％、5．21，差异有统计学意义(P<0．05)。结论瓣膜置换同期双极射频消融术治疗房颤操作安全、临床效果满意，值得推广。【关键词】瓣膜置换术；双极射频消融术；心房纤颤Eficacyofcardiacvalvereplacementandbipolarr

3、adiofrequencycatheterablationonatrialfibrillationCHENHong—wei，PANYan-peng，CHENWen—kuan，ZHANHal—bo，CHENGang．DepartmentofCardiacSurgery，theSeventhPeopleHospitalofZhengzhou，Zhengzhou450016，China【Abstract】ObjectiveToinvestigatetheefficacyofcardiacvalverepl

4、acementandbipolarradiofrequencycatheterablationcontemporaneous(theimprovementoftheoperationofMazelII)onatrialfibrillation．MethodsFromOctober2010toSeptember2012，56caseswithrheumaticheartdiseasecomplicatedwithatrialfibrillationweredividedintotwogroups．Ob

5、servationgroupwasgivencardiacvalvereplacementandbipolarradiofrequencycatheterablationcontemporane—OUS．Controlgroupwasgivencardiacvalvereplacementwithoutsurgicaltreatmentofatrialfibrillation．Theeficacyoftwogroupswascompared．ResultsTherewasnosignificantd

6、ifferencesmortalitybetweentwogrouppatients．Observationgrouphadnotcomplicationrelatedtobipolarradiofrequencycatheterablation．Andinthisgroup，theSuccessrateofrevers—ingAFonthesamedayoftheoperation，oneweeklater，onemonthlater，threemonthslater，andoneyearlate

7、roftheop—erationwas94．1％、88．2％、84．3％、78．9％、76．2％，whichwashigherthanthatofthecontrolgroup(22．7％、5．68％、5．51％、5．64％、5．21％)，thedifferencesweresignificant．(P<0．05)．ConclusionsThecardiacvalvereplacementandbybipolarradiofrequencycatheterablationcontemporaneou

8、stotreatatrialfibrillationissafe，andisworthyofpro—motion．【Keywords】Cardiacvalvereplacement；Bipolarradiofrequencycatheterablation；Atrialfibrillation风湿性心脏瓣膜病最常见的并发症是心房颤动(atrial规行12导联心电图，结果均提示心房纤颤，其中二尖瓣单瓣膜fibrillation，AF)，已经成为威胁心脏瓣膜疾病患者生活质