经皮左心耳封堵术对房颤预防卒中的效果与安全性探讨

The Effect and Safety of Percutaneous Left Atrial Appendage Closure on Atrial Fibrillation in Preventing Stroke

目的探究将经皮左心耳封堵术应用于房颤预防卒中的效果,分析其临床安全性。方法将2017年9月—2019年6月,本院收治的完成左心耳封堵器植入的房颤患者18例作为本次试验对象,在患者手术完成前对患者进行资料采集并记录患者的心功能,在手术后3个月对患者进行再次随访,确认患者的并发症发生状况及心功能变化,同时明确患者的卒中事件发生率。结果在手术完成后,患者的心肌功能相较于手术前明显改善,治疗前后比较差异有统计学意义(P <0.05);患者在治疗完成后存在不同程度的并发症,但未见严重并发症,未见凝血功能异常患者,总发生率为33.33%(6/18),而其中仅有1例患者出现卒中,发生率为5.56%(1/18)。结论在确认患者的基本资料良好后,应用经皮左心耳封堵术对患者进行治疗,能够有效预防房颤脑卒中事件的发生,这种手术在应用时安全有效,患者出现的并发症发生率较低,术后不用终身抗凝治疗,具有较高的临床应用价值,值得推广。

Objective To explore the effect of percutaneous left atrial appendage closure on atrial fibrillation to prevent stroke,and to analyze its clinical safety.Methods From September 2017 to June 2019,18 patients with atrial fibrillation who completed the left atrial appendage occluder implantation were selected as the experimental objects.Before the completion of the operation,the data were collected and the cardiac function of the patients was recorded.The patients were followed up 3 months after the operation to confirm the occurrence of complications and cardiac function changes,and to determine the occurrence of stroke events rate.Results After the operation was completed,the patients'myocardial function was significantly improved compared to before the operation,and the difference was statistically significant before and after treatment(P<0.05);the patient had various degrees of complications after the treatment was completed,but overall it was not serious complications,no patients with abnormal coagulation function,the total incidence rate was 33.33%(6/18),and only one patient had a stroke condition,the incidence rate was 5.56%(1/18).Conclusion After confirming that the basic information of the patient is good,the treatment of the patient with percutaneous left atrial appendage occlusion can effectively prevent the occurrence of atrial fibrillation stroke events.This operation is safe and effective when applied.The incidence of complications in patients low,no life-long anticoagulation treatment is required after surgery,and it has high clinical value and is worth promoting.