论文部分内容阅读
目的:探讨心房颤动(房颤)射频消融术后出现无症状性心包积液的危险因素。方法:选择首次接受房颤射频消融治疗的患者166例,术中根据房颤类型、肺静脉隔离情况,实施环肺静脉电隔离或肺静脉电隔离+左房消融径线的消融术式。术前及术后24 h常规行经胸心脏彩超检查,术后筛选出少量心包积液且无症状的患者,将心包积液与各危险因素进行统计分析。结果:房颤射频消融术后出现无症状性心包积液31例(心包积液组),无心包积液135例(非心包积液组)。心包积液组中阵发性房颤、非阵发性房颤分别为13例、18例,非心包积液组中分别为101例、34例(P=0.001)。心包积液组手术时间为(183.06±78.07)min,非心包积液组为(149.11±51.29)min,差异有统计学意义(P=0.005)。心包积液组术中电复律19例,非心包积液组37例(P=0.001)。消融术式:心包积液组中肺静脉电隔离术、肺静脉电隔离术+左房消融径线分别为6例、25例,非心包积液组中分别为61例、74例(P=0.003)。心包积液组的左房直径为(45.03±5.69)mm,非心包积液组为(41.41±6.59)mm,差异有统计学意义(P=0.005)。多因素Logistic回归分析显示,手术持续时间是房颤射频消融术后出现无症状性心包积液的独立危险因素[β=0.009,Exp(β)=1.009,Exp(β)的95%CI为:1.001～1.017,P=0.027]。结论:房颤射频消融手术持续时间长的患者中,术后易出现无症状性心包积液。
Objective: To investigate the risk factors of asymptomatic pericardial effusion after radiofrequency ablation of atrial fibrillation (AF). Methods: One hundred and sixty-six patients were selected for the first time to undergo radiofrequency ablation of atrial fibrillation. According to the type of atrial fibrillation and isolation of pulmonary veins during operation, the ablation technique of pulmonary vein isolation or pulmonary vein isolation plus left atrium ablation was performed. Preoperative and postoperative 24 h routinely through the chest color Doppler ultrasound, a small amount of pericardial effusion after screening and asymptomatic patients, the pericardial effusion and the risk factors for statistical analysis. Results: There were 31 cases of asymptomatic pericardial effusion (pericardial effusion group) and 135 cases of pericardial effusion (non-pericardial effusion group) after RFA. Pericardial effusion group paroxysmal atrial fibrillation, non-paroxysmal atrial fibrillation were 13 cases, 18 cases, non-pericardial effusion were 101 cases, 34 cases (P = 0.001). The operative time of pericardial effusion group was (183.06 ± 78.07) min and that of non-pericardial effusion group was (149.11 ± 51.29) min, the difference was statistically significant (P = 0.005). In the pericardial effusion group, there were 19 cases of cardioversion and 37 cases of non-pericardial effusion group (P = 0.001). In the pericardial effusion group, there were 6 cases in 6 cases, 25 cases in non-pericardial effusion group, and 74 cases in non-pericardial effusion group (P = 0.003) . The left atrium diameter was (45.03 ± 5.69) mm in the pericardial effusion group and (41.41 ± 6.59) mm in the non-pericardial effusion group, with a significant difference (P = 0.005). Multivariate logistic regression analysis showed that the duration of surgery was an independent risk factor for asymptomatic pericardial effusion after radiofrequency catheter ablation (β = 0.009, Exp (β) = 1.009, 95% CI for Exp (β) 1.001 ~ 1.017, P = 0.027]. CONCLUSIONS: Asymptomatic pericardial effusion is likely to occur in patients with long duration of AF radiofrequency ablation.