摘要
目的探讨心房颤动（房颤）患者射频消融术后急性胃动力损伤的发生率和相关危险因素。方法本研究前瞻性连续观察了2014年11月至2016年3月在南京医科大学第一附属医院41例行射频消融术的患者[房颤34例，阵发性室上性心动过速（室上速）7例]，分别在术前和术后应用钡条法测定了患者的胃排空率（餐后5h），评估研究组房颤患者和对照组室上速患者的胃动力在术后是否损伤，并探究房颤患者射频消融术后急性胃动力损伤的发生率和危险凶素。结果共获取41例患者完整数据纳入研究。其中34例房颤患者术前胃排空率平均为95％±10％，术后平均为77．5％±56．0％，较术前显著降低，差异具有统计学意义（P〈0．05），新发生的胃排空延迟患者数为9／34（26．5％）。7例室上速患者术前胃排空率平均为85％±40％，术后平均为75％±50％，较术前差异无统计学意义（P=0．172），术后新发生胃排空延迟人数为0。多元线性回归分析得出体质指数（BMI）和术中X线曝光时间是胃动力损伤程度的危险因素，BMI越大，X线曝光时间越长，胃动力损伤越严重。结论房颤射频消融术后急性胃动力损伤发生率很高，其中BMI、手术X线曝光时间是胃动力损伤的危险因素。
Objective To investigate the incidence and risk factors of post-ablation gastric dysmotility by evaluation of gastric motility with radio-opaque markers. Methods We prospectively observed 41 patients who underwent radiofrequency ablation [ 34 with atrial fibrillation （AF） and 7 with paroxysmal supraventricular tachycardia （PSVT） ] between November 2014 and March 2016 at the First Affiliated Hospital of Nanjing Medical University and swallowed radio-opaque markers to evaluate gastric emptying rate before and after the procedure, respectively. Results In patients with AF, the average gastric emptying rate before ablation was 95%- 10% and decreased to 77.5 %± 56.0% after ablation （P〈 0.05） .The new incidence of gastric dysmotility after ablation was 26.5% in patients with AF.However in patients with PSVT,the average gastric emptying rate was 85% ±40% before ablation and 75%±50% after ablation, respectively （P=0. 172）.Multiple linear regression showed that body mass index （BMI, P = 0. 001 ） and fluoroscopy time （P=0. 014）were risk factors for gastric dysmotility among AF patients. Conclusion The incidence of gastric dysmotility is high in patients with AF who undergo catheter ablation.BMI and fluoroscopy time are the risk factors for gastric dysmotility.
出处
《中华心律失常学杂志》
2017年第6期480-484,495,共6页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
射频消融
胃动力
Atrial fibrillation
Catheter ablation
Gastric motility
