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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (5): 66-70.doi: 10.6040/j.issn.1671-7554.0.2014.479

• 临床医学 • 上一篇    下一篇

同期射频消融改良迷宫Ⅲ术+心脏神经节丛消融术与单纯射频消融改良迷宫Ⅲ术治疗合并风湿性二尖瓣病变的心房颤动比较

张凯1, 梁飞1, 韩波2, 马晓春1, 朱小龙1, 张军1, 张涛1, 邹承伟1   

  1. 1. 山东大学附属省立医院心脏外科, 山东 济南 250021;
    2. 济南市第四人民医院心脏外科, 山东 济南 250031
  • 收稿日期:2014-07-22 修回日期:2015-02-28 出版日期:2015-05-10 发布日期:2015-05-10
  • 通讯作者: 邹承伟。E-mail:zouchengwei@sdu.edu.cn E-mail:zouchengwei@sdu.edu.cn
  • 基金资助:
    山东省医药卫生科技发展计划(2011HZ073);济南市科技计划 (201202052)

Radiofrequency modified maze Ⅲ plus ganglionic plexus ablation vs radiofrequency modified maze Ⅲ alone in the treatment of atrial fibrillation with rheumatic mitral lesion

ZHANG Kai1, LIANG Fei1, HAN Bo2, MA Xiaochun1, ZHU Xiaolong1, ZHANG Jun1, ZHANG Tao1, ZOU Chengwei1   

  1. 1. Department of Cardiac Surgery, Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shangdong, China;
    2. Department of Cardiac Surgery, The Forth People's Hospital of Jinan, Jinan 250031, Shangdon, China
  • Received:2014-07-22 Revised:2015-02-28 Online:2015-05-10 Published:2015-05-10

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摘要： 目的 比较直视下射频消融改良迷宫Ⅲ术(RFMM Ⅲ)+心脏神经节丛(GP)消融术与单纯RFMM Ⅲ术治疗合并风湿性二尖瓣病变的心房纤颤疗效。方法 回顾性分析因风湿性二尖瓣病变合并心房纤颤接受RFMM Ⅲ 术+心脏GP消融术100例(GP组)及同期行单纯RFMM Ⅲ 术100例(单纯组)患者的资料,对两组患者围手术期与1、6、12个月随访期内的各项临床指标进行比较分析。结果 术后1、6、12个月的随访中,GP组窦性心律者均高于单纯组(P依次为0.03、0.02及0.03)。术后12个月随访结果显示单纯组三尖瓣返流情况加重较GP组高(P=0.038),同时单纯组心房扩大也较GP组明显(P=0.04)。结论 RFMM Ⅲ术+心脏GP消融术治疗合并风湿性二尖瓣病变心房纤颤疗效优于既往单纯RFMM Ⅲ术,有效转复律及窦律维持率高且复发率低,能有效改善二尖瓣置换术后患者三尖瓣返流情况,有利于远期预后。

关键词: 心脏神经节丛, 心房颤动, 消融, 改良迷宫Ⅲ手术

Abstract: Objective To compare the efficacy and safety of radiofrequency modified maze Ⅲ (RFMM Ⅲ) plus ganglionic plexus (GP) ablation with RFMM Ⅲ alone in the treatment of atrial fibrillation with rheumatic mitral lesion. Methods A retrospective analysis was performed to analyze the clinical data of 200 patients who underwent RFMM Ⅲ plus GP ablation (n=100, GP group) or RFMM Ⅲ alone (n=100, solo group) in the treatment of atrial fibrillation with rheumatic mitral lesion. Results The sinus rhythm maintenance rate in the GP group was higher than that of the solo group 1, 6 and 12 months after operation (P=0.03, 0.02 and 0.03, respectively). The solo group showed a higher incidence of aggravating tricuspid regurgitation and more obvious left atria enlargement than the GP group 12 months after operation (P=0.03). Conclusion RFMM Ⅲ plus GP ablation, with higher sinus rhythm maintenancerate and lower recurrence rate, might be superior to RFMM Ⅲ alone in the treatment of atrial fibrillation with rheumatic mitral lesion, which might effectively improve tricuspid regurgitation in patients undergoing mitral valve replacement and be beneficial for their long-term prognosis.

Key words: Radiofrequency Modified Maze Ⅲ, Ganglionic Plexus, Ablation, Atrial Fibrillation

中图分类号: 

  • R654.2
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