液氮冷冻加切开缝合的改良迷宫手术治疗心房纤颤

Treatment of Atrial Fibrillation with Modified Maze Procedure with Liquid Nitrogen Refrigeration and Incised Suture

目的探讨液氮冷冻加切开缝合的改良迷宫手术治疗心房纤颤。方法２６例风湿性心脏病伴心房纤颤的病人行瓣膜替换术或成形术，同时应用液氮冷冻加切开缝合的改良迷宫手术治疗心房纤颤。结果术中心脏复跳后，心房纤颤均消失，恢复窦性心律。术后２周内５例出现频发房性早搏，１例术后１２天出现频发房性早搏及短暂房扑，１例术后第７天出现房颤与窦性心律交替，经服用乙胺碘呋酮或氨酰心安后心律失常消失。术后随访６～１８个月，心电图均示窦性心律，有２例偶有房性早搏。复查心脏彩超示房室收缩协调，ＥＦ有不同程度提高。心功能均转为Ⅰ～Ⅱ级。结论液氮冷冻加切开缝合的改良迷宫手术治疗心房纤颤的效果是满意的。

Objective\ To demonstrate treatment of atrial fibrillation with modified maze procedure of liquid nitrogen refrigeration.\ Methods\ 26 patients suffering from rheumatic valvular heart disease with atrial fibrillation received modified maze procedure of liquid nitrogen refrigeration and with valve replacement or valvuloplasty at same time.\ Results\ During the operation,after cardiac resuscitation,atrial fibrillation disappeared and sinus rhythm resumed.\ All the Patients in this group were discharged from the hospital in good condition.Within two weeks after operation,frequent atrial extrasystoles occurred in 5 cases,12 days after operation,frequent atrial extrasystoles and transient auricular flutter developed in 1 case.7 days after operation,the alternation of atrial fibrillation and sinus rhythm occurred in 1 case,with administration of amiodarone or atenotol hydrochloride arrhythmia disappeared.6～18 months′ follow up after operation all electrocardiograms showed sinus rhythm. Two patients had occasional atrial extrasystoles. In reexamination,cardiac color ultrasonograph showed coordination of atrioventricular contraction. EF was increased to varying degrees and cardiac functions turned to grade Ⅰ～Ⅱ.\ Conclusion\ The modified maze procedure of liquid nitrogen refrigeration has received satisfactory results.