心房颤动射频消融术后假性动脉瘤的形成及护理

Causes and Nursing of Femoral Pseudoaneurysm after Radiofrequency Ablation of Atrial Fibrillation

目的探讨心房颤动(atrial fibrillation,AF)射频消融术后假性动脉瘤形成原因及护理要点。方法对2004年1月-2007年12月共409例AF患者行射频消融术,对术后假性动脉瘤形成的影响因素进行分析,总结假性动脉瘤形成原因及相应的护理对策。结果AF射频消融术后共7例发生假性动脉瘤形成,假性动脉瘤发生率1.7%;左下肢2例(28.5%),右下肢5例(71.5%)。在超声引导下压迫假性动脉瘤后,6例动脉瘤颈部闭合,1例术后假腔形成。随访半年6例B超检查正常,1例假腔明显缩小,无需外科干预,所有患者患肢均无功能障碍。结论加强早期观察,明确渗血来源部位,早期局部压迫,针对不同原因采取有效的护理措施,可降低假性动脉瘤的发生率,加速其愈合。

Objective To investigate the causes and nursing of femoral pseudoaneurysm（FP） after radiofrequency ablation of atrial fibrillation（AF）. Methods The causes and influencing factors of FP were retrospectively analyzed and the appropriate countermeasures were summarized by the clinical data of 409 patients with AF underwent radiofrequency catheter ablation （ RFCA） from 2004 to 2006. Results FP were found in 7 cases （ 1.7% ） after the RFCA, among which Left side 2 cases and right side 5 cases. By B-Ultrasounds guided compression,the neck of FP was occluded in six patients,and false lumen occurred in 1 patient, follow up was 6 months, B-Ultrasounds showed that six cases of FP disappeared completely and 1 case of false lumen shrunk obviously. No patients had functional impairment or needed surgical intervention. Conclusions The effective measures, such as early observation, identification of bleeding source, local oppressing on the early stage, and appropriate nursing measures can accelerate the healing process and reduce the incidence of FP.