Swartz鞘管在射频消融术中的临床应用

Application of Swartz introducer in radiofrequency current ablation

应用Ｓｗａｒｔｚ导管对２６例（２８条旁道）房室折返性心动过速（ＡＶＲＴ）病人（Ａ组）进行射频消融术，右侧房室旁道１６条，左侧旁道１２条，并与５２例（５４条旁道）常规方法消融结果（Ｂ组）比较，结果显示，１６条右侧房室旁道消融均获成功，平均消融功率（２７．８±６．０）Ｗ（Ｐ＞０．０５），平均有效放电次数（３．４±３．２）次（Ｐ＜０．０５），Ｘ线照射时间１９～４６ｍｉｎ（２９．２±８．８ｍｉｎ，Ｐ＜０．００１）；左侧１２条旁道１１条消融成功（９１．７％），平均消融功率（２６．７±７．１）Ｗ（Ｐ＞０．０５），平均有效放电次数（２．６±１．７）次（Ｐ＜０．０５），Ｘ线照射时间２０～４９分（２９．４±１４．１ｍｉｎ，Ｐ＜０．０５），无手术并发症发生。随访６～３８个月无复发。结果表明Ｓｗａｒｔｚ鞘管可以减少复杂、疑难病例的射频消融放电次数、缩短Ｘ线照射时间。

26 cases (group A) with 28 atrioventricular accessory pathways (AP) (16 in the rightside and 12 in the left) were ablated with radiofrequency current using Swartz introducer comparingwith 52 cases (group B) with 54 APs using the regular method. The results showed 16 APs in the rightwere successfully ablated (100%), the mean energy was 27. 8+6. 0 Walts (P>0. 05), the mean effective discharge time was 3. 4+ 3. 2 (P<O. 05), the mean X-ray exposure time was 29.2+8. 8 min (1946 min) (P<0. 001 ), and 11 of the 12 APs in the left were ablated successfully (91.7% ), the mean energy was 26. 7+7. 1 Walts (P>0. 05), the mean effective discharge time was 2. 6+1. 7 (P<0. 05), themean X-ray exposure time was 29. 4+14. 1 min (20-49 min) (P<0. 05), there was no complicationsassociated with operations, and there was no recurrence during 6 to 38 month follow-up. It is suggestedthat the effective discharge time and X-ray exposure time of radiofrequency current ablation could be reduced using Swartz introducer.