高龄心房颤动患者射频导管消融术后复发高危因素分析与护理对策

Analysis of high risk factors and nursing strategies related to the recurrence after radiofrequency catheter ablation in elderly patients with atrial fibrillation

目的探讨高龄心房颤动患者射频消融术后复发高危因素与护理对策。方法采用随机抽样法,选择2017年1月至2018年11月在我院心内科行射频导管消融术的高龄心房颤动患者228例作为研究对象,于术后1年进行门诊复查或电话随访,收集患者主诉与24 h动态心电图监测结果,观察患者心房颤动复发情况。采用logistic回归分析术后心房颤动复发的高危因素,并给予针对性护理措施。结果本组术后心房颤动复发62例,复发率为27.19%。多因素logistic回归分析显示,肥胖(OR=4.406)、合并高血压(OR=6.449)、合并糖尿病(OR=4.816)、合并睡眠呼吸暂停综合征(OR=5.737)、左心房内径扩大(OR=4.773)是影响老年心房颤动患者术后复发的高危因素。结论明确高龄心房颤动患者射频导管消融术术后复发的高危因素,为降低消融术后心房颤动复发率、提高患者生命质量提供理论依据。

Objective To explore the high risk factors and nursing strategies related to the recurrence after radiofrequency ablation in elderly patients with atrial fibrillation.Methods To select 228 cases of elderly patients with atrial fibrillation who underwent radiofrequency catheter ablation in our hospital's cardiology department from January 2017 to November 2018 as the study objects by using a random sampling method.The outpatient review or telephone follow-up was carried out at1 year after the operation,and the main complaint of the patients and the monitoring results of 24 h Holter were collected to observe the patient's recurrence of atrial fibrillation.Logistic regression was used to analyze the high-risk factors of postoperative atrial fibrillation recurrence,and targeted nursing measures were given.Results There were 62 cases of postoperative atrial fibrillation recurrence in this group,and the recurrence rate was 27.19%.Multivariate logistic regression analysis showed that the obesity(OR=4.406),combined hypertension(OR=6.449),combined diabetes(OR=4.816),combined sleep apnea syndrome(OR=5.737),and left atrial diameter enlargement(OR=4.773)were the high-risk factors affecting postoperative recurrence in elderly patients with atrial fibrillation.Conclusion Clarifying the high-risk factors for recurrence after radiofrequency catheter ablation in elderly patients with atrial fibrillation,which provided a theoretical basis for reducing the recurrence rate of atrial fibrillation after ablation operation and improving the quality of life of patients.