摘要
目的:探讨二尖瓣置换同期行优化的迷宫Ⅳ术,在治疗二尖瓣疾病合并心房颤动患者中的临床疗效。方法:2016年01月至2020年12月,136例二尖瓣疾病合并心房颤动患者在我科手术治疗,回顾性分析临床资料。其中63例患者二尖瓣置换术同期行经典的迷宫Ⅳ术(经典组),73例患者二尖瓣置换术同期行优化的迷宫Ⅳ(优化组)。经典组男28例,女35例,年龄38~70岁,平均(56.7±12.5)岁;优化组男33例,女40例,年龄42~72岁,平均(58.6±14.3)岁。分析两组患者的一般资料、术前超声心动图结果、围术期资料、出院时及随访心电图和超声心动图结果,分析二尖瓣置换同期行优化的迷宫Ⅳ术,在治疗二尖瓣疾病合并心房颤动患者中的临床疗效。结果:优化组主动脉阻断时间、体外循环时间、手术操作时间、术后呼吸机辅助时间和胸腔引流量均短于经典组,差异有统计学意义(P<0.05)。两组并发症发生率、ICU滞留时间和术后住院时间等,差异无统计学意义(P>0.05)。两组出院时、术后3、6、12个月窦性心律维持率,差异无统计学意义(P>0.05);两组术后6个月LAD、LVEDD、LVEF、肺动脉压及心功能分级等,差异无统计学意义(P>0.05)。结论:优化的迷宫Ⅳ同期二尖瓣置换术治疗二尖瓣疾病合并心房颤动,能缩短手术时间,术后恢复快,随访结果满意。
Objective:To explore the outcomes of mitral valve replacement with optimized maze Ⅳ in the treatment of patients with mitral valve disease and atrial fibrillation.Methods:From Jan.2016 to Dec 2020,136 patients with mitral valve disease combined with atrial fibrillation underwent procedures in our department,and the clinical data were analyzed retrospectively.Among them,63 patients underwent mitral valve replacement with classic mazeⅣ(classic group)and 73 patients underwent mitral valve replacement with optimized maze Ⅳ(optimized group).There were 28 males and 35 females in classic group,aged 38~70 years,the mean age was(56.7±12.5)years;There were 33 males and 40 females in optimized group,with an age of 42~72 years,the mean age was(58.6±14.3)years.Analyze the general data,preoperative echocardiography results,perioperative data,ECG and echocardiography results at discharge and follow-up of the two groups of patients,and analyze the clinical efficacy of optimized maze Ⅳ Operation in the treatment of patients with mitral valve disease and atrial fibrillation after mitral valve replacement at the same time.Results:The aortic cross-clamping time,cardiopulmonary bypass time,operation time,mechanical ventilation time and thoracic drainage volume of the optimized group were shorter than those of the classic group,and the difference was statistically significant(P<0.05).There was no statistical difference in the incidence of complications,ICU stay time and postoperative hospitalization time between the two groups(P<0.05).There was no significant difference in sinus rhythm maintenance rate between the two groups at discharge and 3,6 and 12 months after operation(P<0.05);There was no significant difference in LAD,LVEDD,LVEF,pulmonary artery pressure and cardiac function between the two groups at 6 months after operation(P<0.05).Conclusions:The optimized maze Ⅳ with mitral valve replacement for mitral valve disease combined with atrial fibrillation can shorten the operation time,recover quickly after operation a
作者
姚碧
杨伟伟
郭晓珂
王为新
郑善光
安国营
张洪宇
YAO Bi;YANG Weiwei;GUO Xiaoke;WANG Weixin;ZHENG Shanguang;AN Guoying;ZHANG Hongyu(Department of Cardiac Surgery and Medical Records,Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases,Affiliated Hospital of Jining Medical University,Jining 272000,China)
出处
《心肺血管病杂志》
CAS
2023年第5期444-448,共5页
Journal of Cardiovascular and Pulmonary Diseases
基金
济宁市重点研发计划资助项目(2020YXNS002)。
关键词
迷宫IV术
二尖瓣手术
置换
心房颤动
MazeⅣ
Mitral valve surgery
Replacement
Atrial fibrillation
