自制高频电刀双房消融与单纯左房射频消融治疗房颤的对比

Comparative analysis of self-made HF electrosurgical two-chamber ablation and left atrial radiofrequency ablation for atrial fibrillation

目的对比获得国家发明专利的自制高频电刀双房消融术与单纯左房介入射频消融术治疗瓣膜性房颤的优劣性。方法选取2021年1月至2022年1月济南市第四人民医院收治的瓣膜性房颤患者66例,采用随机数字表法将患者分为A组(高频电刀组)和B组(介入射频组)。A组患者实施高频电刀双房消融治疗,B组患者实施左房介入射频消融治疗。比较两组患者手术消融时间、治疗后的临床疗效。术后1年对这些患者行动态心电图及超声心动图检测两组患者左心房内径(LA)、左心室内径(LV)、左心室射血分数(LVEF)。组间计量数据比较采用t检验。结果术后1年A组窦性心律维持率[31例(93.94%)]远高于B组窦性心律维持率[22例(70.97%)],差异有统计学意义(t=4.422,P<0.05)。术后1年所有患者LA[(40.89±2.91)mm]明显低于术前LA[(48.16±3.79)mm],差距有统计学意义(t=12.176,P<0.05)。术后1年所有患者LVEF值[(56.47±5.05)%]明显高于术前LVEF[(52.14±9.02)%],差距有统计学意义(t=3.350,P<0.05)。术后1年所有患者LV相近[(48.31±4.40)]与术前LV[(47.91±4.30)],差异无统计学意义(t=0.528,P>0.05)。术后1年A组患者LA[(39.85±2.75)mm]水平明显低于B组[(42.00±2.68)mm],差异有统计学意义(t=3.164,P<0.05)。术后1年A组患者LV[(49.03±4.19)mm]、LVEF[(55.97±5.33)%]与B组患者LV[(47.55±4.60)mm]、LVEF相近[(57.00±4.76)%],差异无统计学意义(t=1.354、0.814,P>0.05)。射频消融时间A组[(11.39±2.61)min]明显少于B组[(59.10±2.89)min],差异有统计学意义(t=69.373,P<0.05)。结论自制高频电刀治疗瓣膜性房颤效果显著,可显著提升瓣膜性房颤的临床治疗疗效,有效改善患者的心功能。

Objective To compare and analyze the advantages and disadvantages of self-made high-frequency electrosurgical double-chamber ablation,which obtained national invention patent,and left atrial interventional radiofrequency ablation for the treatment of valvular atrial fibrillation.Methods Sixty-six patients with valvular atrial fibrillation admitted to Jinan Fourth People’s Hospital from January 2021 to January 2022 were selected and divided into group A(high-frequency electrotome group)and group B(interventional radio frequency group)by random number table method.Patients in group A underwent double-atrial ablation with high-frequency electrotome,and patients in group B underwent left atrial interventional radiofrequency ablation.The ablation time and the clinical effect after treatment were compared between the two groups.The left atrial diameter(LA),left ventricular diameter(LV)and left ventricular ejection fraction(LVEF)were measured by holter electrocardiography and echocardiography 1 year after operation.T test was used to compare measurement data between groups.Results 1 year after operation,the sinus rhythm maintenance rate of group A[31 cases(93.94%)]was much higher than that of group B[22 cases(70.97%)],and the difference was statistically significant(t=4.422,P<0.05).LA[(40.89±2.91)mm]1 year after surgery was significantly lower than that before surgery[(48.16±3.79)mm],and the difference was statistically significant(t=12.176,P<0.05).LVEF[(56.47±5.05)%]1 year after operation was significantly higher than that before operation[(52.14±9.02)%],and the difference was statistically significant(t=3.350,P<0.05).LV at 1 year after operation[(48.31±4.40)]was similar to that before operation[(47.91±4.30)],and the difference was not statistically significant(t=0.528,P>0.05).One year after surgery,the LA[(39.85±2.75)mm]level in group A was significantly lower than that in group B[(42.00±2.68)mm],and the difference was statistically significant(t=3.164,P<0.05).One year after surgery,LV[(49.03±4.19)mm]and LVEF[(55.97±5.33)%]in group A were similar to LV[(47.55±4.60)mm]and LVEF[(57.00±4.76)%]in group B,and the difference was not statistically significant(t=1.354,0.814,P>0.05).The radiofrequency ablation time in group A[(11.39±2.61)minutes]was significantly less than that in group B[(59.10±2.89)minutes],and the difference was statistically significant(t=69.373,P<0.05).Conclusion Self-made high-frequency electrotome is effective in the treatment of valvular atrial fibrillation,which can significantly improve the clinical therapeutic effect of valvular atrial fibrillation and effectively improve the heart function of patients.