持续性心房颤动Marshall静脉无水乙醇消融术后心包炎的特点及处理

Characteristics and management of pericarditis after vein of Marshall ethanol infusion for persistent atrial fibrillation

目的 总结持续性心房颤动(简称房颤)Marshall静脉无水乙醇消融(EI-VOM)术后心包炎的特点及处理。方法 回顾性研究连续纳入接受导管消融联合EI-VOM的持续性房颤患者。根据术后是否发生心包炎分为心包炎组和无心包炎组,比较两组的基线特征,以logistic回归分析心包炎的危险因素。心包炎的治疗效果以用药后胸痛的缓解时间和缓解程度评价,其中胸痛程度以视觉模拟评分(VAS)判断。结果 纳入的81例患者中有7例发生术后心包炎。logistic回归分析未找到EI-VOM后心包炎发生的危险因素。秋水仙碱治疗的4例心包炎症状在48 h内均完全缓解,1例有不良反应。单纯非甾体抗炎药(NSAIDs)治疗的3例,心包炎的症状缓解时间在48 h至72 h。结论 心包炎是EI-VOM术后不可忽视的并发症之一,秋水仙碱与NSAIDs均对其具有良好的短期疗效。

Objective To summarize the characteristics and management of pericarditis after the vein of Marshall ethanol infusion(EI-VOM)for persistent atrial fibrillation(AF).Methods A retrospective study was conducted on patients with persistent atrial fibrillation who underwent catheter ablation combined with EI-VOM.According to the occurrence of pericarditis after surgery,the patients were divided into two groups:the pericarditis group and the non-pericarditis group.The baseline characteristics of the two groups were compared,and the risk factors for pericarditis were analyzed using logistic regression.The treatment effect of pericarditis was evaluated by the time and degree of relief of chest pain after medication,with the degree of chest pain determined by visual analogue scale(VAS).Results Among the 81 patients included,7 experienced postoperative pericarditis.The logistic regression analysis did not find any risk factors for the occurrence of pericarditis after EI-VOM.4 cases of pericarditis treated with colchicine completely relieved symptoms within 48 h,with one adverse reaction.Three cases treated with simple nonsteroidal anti-inflammatory drugs(NSAIDs)showed a symptom relief time of 48 to 72 h for pericarditis.Conclusion Pericarditis is one of the complications that cannot be ignored after EI-VOM surgery,and both colchicine and NSAIDs have good short-term therapeutic effects on it.