摘要
目的评价双极消融术治疗瓣膜相关性房颤后患者远期复发的危险因素进行分析。方法回顾性分析2012年11月~2016年1月在天津市胸科医院行双极射频消融术治疗的房颤患者161例,按照随访第3年房颤复发情况,将患者分为复发组(45例)和无复发组(86例),比较两组年龄、性别、合并症发生情况(糖尿病、高血压、左房血栓、冠心病等)、左房前后径、左室舒张末径、围术期并发症发生情况(出血、心包填塞)及手术相关指标(体外循环时间、主动脉阻断时间);单因素和多因素Logistic回归分析房颤外科射频消融术后远期复发的危险因素。结果住院期间有3例患者死亡,复发组2例,无复发组1例;术后3个月、6个月、1年、2年、3年随访患者分别为161例、159例、157例、140例、131例,房颤复发率分别为29.19%、31.11%、33.82%、34.29%、33.59%;两组性别、合并症发生情况、烟酒史、心功能、右房前后径、左室舒张末径、左室射血分数比较,差异无统计学意义(P>0.05),复发组年龄、病程、左心房前后径均大于无复发组,差异有统计学意义(P<0.05);复发组心肺转流时间长于无复发组,二次手术比例高于无复发组,差异有统计学意义(P<0.05),两组主动脉阻断时间、心包填塞发生率、30天死亡率、ICU停留时间、术后住院时间比较,差异无统计学意义(P>0.05);多因素分析显示,年龄、房颤病程、左房前后径是患者术后复发的独立危险因素。结论双极射频消融治疗瓣膜相关性房颤疗效可靠,但患者术后可能存在复发风险,其中年龄、房颤病程、左房前后径是患者远期复发的独立危险因素。
Objective To evaluate and analyze the risk factors for long-term recurrence of patients with valve-related atrial fibrillation after bipolar ablation.Methods A retrospectively enrolled 161 patients with atrial fibrillation who underwent bipolar radiofrequency ablation in Tianjin Chest Hospital from November 2012 to January 2016.According to the recurrence of atrial fibrillation in the third year of follow-up,the patients were divided into a recurrence group(45 cases)and a non-recurrence group(86 cases).Compare the two groups’age,gender,comorbidity(diabetes,hypertension,left atrial thrombosis,coronary heart disease,etc.),left atrium anterior and posterior diameter,left ventricular end diastolic diameter,and perioperative complications(bleeding,pericardial tamponade)And surgery-related indicators(extracorporeal circulation time,aortic block time);Univariate and multivariate Logistic regression analysis of risk factors for long-term recurrence after radiofrequency ablation of atrial fibrillation.Results 3 patients died during hospitalization,2 in the recurrence group and 1 in the non-recurrence group;There were 161 cases,159 cases,157 cases,140 cases,and131 cases followed up at 3 months,6 months,1 year,2 years,and 3 years after operation,respectively.The recurrence rates of atrial fibrillation were29.19%,31.11%,33.82%,34.29%,33.59%;the two groups were gender,comorbidity,smoking and alcohol history,cardiac function,right atrium anterior and posterior diameter,left ventricular end diastolic diameter,and left ventricle comparison of ejection fraction,the difference was not statistically significant(P>0.05),the age,course of disease,and anteroposterior diameter of the left atrium in the recurrence group were larger than those in the non-recurrence group,the difference was statistically significant(P<0.05);The cardiopulmonary bypass time of the recurrence group was longer than that of the non-recurrence group,and the proportion of secondary operations was higher than that of the non-recurrence group,the difference was
作者
孙盛斌
商宏伟
白云鹏
郭志刚
SUN Sheng-bin;SHANG Hong-wei;BAI Yun-peng;GUO Zhi-gang(Clinical College of Thoracic Medicine,Tianjin Medical University,Tianjin 300000,China;Department of Cardiothoracic Surgery,983 Hospital of Joint Logistics Support Force,Tianjin 300000,China;Department of Cardiac Surgery,Tianjin Chest Hospital,Tianjin 300000,China)
出处
《医学信息》
2021年第11期83-86,共4页
Journal of Medical Information
关键词
心房颤动
双极射频消融术
远期复发
Atrial fibrillation
Bipolar radiofrequency ablation
Long-term recurrence
