CAJ | 학술논문

目的:探讨在三维电解剖标测(Three-dimensional electroanatomical mapping,CARTO)系统指导下进行射频消融治疗心房颤动的护理方法及并发症的处理.方法:对81例反复发作的阵发性房颤和17例持续性房颤行射频消融术治疗的患者进行观察和护理.术前做好心理护理,术后密切观察患者生命体征,加强并发症的观察和护理.结果:87.65%(71/81)的阵发性房颤(随访时间16±5)和58.82%(10/17)的持续性房颤患者(随访时间13±5)维持窦性心律,二组间窦性心律的维持率有显著差异(P<0.05).窦性心律下房颤消融的手术时间显著短于房颤节律下的消融时间(188±30与243±26 min,P<0.01).本组有2例患者出现心包填塞,1例胸壁血肿,1例中重度肺静脉狭窄,1例急性胃扩张,总的并发症发生率为5.1%,经护理和治疗后全部康复.结论:CARTO三维标测系统指导下行射频消融治疗房颤安全有效.规范化的护理是取得良好疗效的重要保障.
목적:탐토재삼유전해부표측(Three-dimensional electroanatomical mapping,CARTO)계통지도하진행사빈소융치료심방전동적호리방법급병발증적처리.방법:대81례반복발작적진발성방전화17례지속성방전행사빈소융술치료적환자진행관찰화호리.술전주호심리호리,술후밀절관찰환자생명체정,가강병발증적관찰화호리.결과:87.65%(71/81)적진발성방전(수방시간16±5)화58.82%(10/17)적지속성방전환자(수방시간13±5)유지두성심률,이조간두성심률적유지솔유현저차이(P<0.05).두성심률하방전소융적수술시간현저단우방전절률하적소융시간(188±30여243±26 min,P<0.01).본조유2례환자출현심포전새,1례흉벽혈종,1례중중도폐정맥협착,1례급성위확장,총적병발증발생솔위5.1%,경호리화치료후전부강복.결론:CARTO삼유표측계통지도하행사빈소융치료방전안전유효.규범화적호리시취득량호료효적중요보장.
Objective: To explore nursing methods and treatment of complications after catheter ablation guided by Carto mapping in patients with atrial fibrillation.Methods: Eighty-one cases of paroxysmal atrial fibrillation and seventeen eases of persistent atrial fibrillation were observed and nursed intensively after treatment.The mental nursing was conducted before the ablative procedure,and vital signs were obversed during and after the procedure,and the complications were observed and cared intensively.Results:Seventy-one patients(87.65%,71/81)with paroxysmal atrial fibrillation were under sinus rhythm during 16 months follow-up period,ten patients (58.82%,10/17)with persistent atrial fibrillation were also under sinus rhythm during 13 months follow-up period.The rate of atrial fibrillation-free survival between paroxysmal AF and persistent AF had significant difference(P<0.05).Procedural time in patients with sinus rhythm during the ablation was significantly shorter than that in patients with AF rhythm(188±30 vs243±26min,P<0.01).Two patients suffered from cardiac tamponade,one patient from subclavieal haematoma,one from serious stenosis of pulmonary vein.and one from acute dilatation of stomack.The total incidence rate of complications was 5.1%.All patients with complications were recovered under intensive nursing and treatment. Conclusion:The catheter ablation guided by Carto mapping in patients with paroxysmal and persistent AF is effective and safe and intensive and normalized care is great guarantee for optimal efficiacy.