瓣膜置换术联合房颤射频消融术治疗心脏瓣膜病变合并房颤的疗效观察

Effect of Valve Replacement Combined with Atrial Fibrillation Radiofrequency Ablation in the Treatment of Cardiac Valve Disease Combined with Atrial Fibrillation

目的探讨心脏瓣膜病变(HVD)合并心房颤动(房颤,AF)应用瓣膜置换术(VR)与射频消融术(RA)联合治疗的临床疗效。方法选择2016年5月-2019年5月三门峡市中心医院收治的HVD合并AF患者60例进行研究,以电脑随机数法分为两组,每组30例。对照组用VR治疗,观察组联合RA治疗。记录组间术毕转复率与随访3个月时转复率,测定术前与术后3个月时心功能指标、血清炎性因子,并比较。结果观察组术毕转复率与随访3个月时转复率均明显高于对照组(P <0.05);心功能比较,组间术前左心房内径、射血分数、左室舒张末容积对比无显著差异(P> 0.05),术后3个月观察组左心房内径、左室舒张末容积更低,而射血分数更高,与对照组差异显著(P <0.05);血清炎性因子比较,组间术前IL-6与hs-CRP对比无显著差异(P> 0.05),术后3个月观察组均明显低于对照组(P <0.05)。结论 HVD合并AF应用VR联合RA治疗,相比单一VR治疗,可以更好地提高转复率,同时促进心功能与血清炎性因子指标改善,值得临床应用。

Objective To investigate the clinical effect of valve replacement(VR) and radiofrequency ablation(RA) combined with atrial fibrillation(AF) in patients with valvular heart disease(HVD). Methods 60 patients with HVD combined with AF admitted to Sanmenxia Central Hospital from May 2016 to May 2019 were selected for the study, and were divided into two groups with 30 patients in each group by computer random number method. The control group was treated with VR, while the observation group was treated with RA.The recovery rate after surgery and the recovery rate after 3 months of followup were recorded, and the cardiac function indexes and serum inflammatory factors were measured and compared before and 3 months after surgery. Results The recovery rate after operation in the observation group was significantly higher than that in the control group(P < 0.05). There were no significant differences in preoperative left atrial diameter, ejection fraction, and left ventricular end-diastolic volume between the groups(P > 0.05), 3 months after the operation, the observation group had lower left atrial diameter, lower left ventricular end-diastolic volume, and higher ejection fraction, which was significantly different from the control group(P < 0.05);Compared with the serum inflammatory factors, there was no significant difference in preoperative il-6 and hs-crp between the groups(P > 0.05), and the observation group was significantly lower than the control group at 3 months after the operation(P < 0.05). Conclusion Compared with single VR therapy, HVD combined with AF are treated with VR combined with RA can better improve the recovery rate, and promote the improvement of cardiac function and serum inflammatory factor indicators, which is worthy of clinical application.