心脏瓣膜病伴发心房颤动手术同期行单极冲洗射频消融改良迷宫术的效果观察

Effect of modified maze ablation with monopolar irrigation and radiofrequency ablation during the operation of atrial fibrillation with valvular heart disease

目的观察心脏瓣膜病伴发心房颤动手术同期行单极冲洗射频消融改良迷宫术的临床效果。方法选取2017年3月至2018年9月郑州市第七人民医院收治的78例心脏瓣膜病伴发心房颤动患者的临床资料,并根据不同治疗方案将患者分为对照组与观察组,各39例。对照组在手术同期行双极冲洗射频消融改良迷宫术,观察组在手术同期行单极冲洗射频消融改良迷宫术,观察比较两组手术情况、术前、术后1周心电图指标恢复情况以及1年后心功能等级。结果观察组的体外循环时间、主动脉阻断时间与射频消融时间与对照组比较,差异无统计学意义(P>0.05);同时术后1周观察组的左房内径、左室舒张末径小于对照组,且观察组1年后的心功能Ⅰ级(61.54%)所占比高于对照组(38.46%)(P<0.05)。结论心脏瓣膜病伴发心房颤动手术同期行单极冲洗射频消融改良迷宫术能有效改善患者的心功能。

【Objective】To observe the clinical effect of modified maze ablation with monopolar irrigation and radiofrequency ablation at the same time.【Methods】From March 2017 to September 2018,78 patients with heart valve disease and atrial fibrillation were selected and divided into control group and observation group with 39 cases in each group according to different treatment schemes.At the same time of operation,the control group was treated with bipolar irrigation and radiofrequency ablation modified maze,while the observation group was treated with monopolar irrigation and radiofrequency ablation modified maze.【Results】The time of cardiopulmonary bypass,aortic occlusion and radiofrequency ablation in the observation group were the same as those in the control group,with no significant difference(P>0.05);at the same time,the left atrial diameter and the end diastolic diameter in the observation group were smaller than those in the control group,and the proportion of grade I cardiac function in the observation group one year later(61.54%)was higher than that in the control group(38.46%)(P<0.05).【Conclusion】The heart function of patients with valvular heart disease accompanied by atrial fibrillation can be effectively improved by the modified maze procedure of single pole RF ablation.