中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2009年
7期
630-633
,共4页
谷宏越%石铭宇%赵永伟%尹雪松%曲秀芬
穀宏越%石銘宇%趙永偉%尹雪鬆%麯秀芬
곡굉월%석명우%조영위%윤설송%곡수분
导管消融术%心肌%冠状血管%创伤和损伤
導管消融術%心肌%冠狀血管%創傷和損傷
도관소융술%심기%관상혈관%창상화손상
Catheter ablation%Myocardium%Coronary vessels%Wounds and injuries
目的 分析应用不同射频导管电极消融房室环处心肌组织的损伤范围及其邻近冠状动脉(冠脉)的损伤,评价其临床应用的安全性.方法 取成年犬21只,随机分为3个能量组:64℃、50 W、100 s,64℃、100 W、100 s,45℃、45 W、100 s;分别应用4、8 mm电极及冷盐水灌注电极进行消融(分别简称4 mm组、8 mm组和冷盐水组).每只犬分别消融左、右房室环各1处.实验结束后以1/6π×长×宽×深计算损伤体积并对损伤的心肌及冠脉组织进行光学显微镜病理学分析.结果 观察损伤深度:4mm组为(4.54±1.38)mm,8mm组为(7.18±1.72)mm,冷盐水组为(7.99±1.77)mm.统计学分析:4 mm组与8mm组和冷盐水组的组间相比,差异均具有统计学意义(P<0.01);后两组组间的差异无统计学意义.损伤体积:4mm组为(191.34±74.52)mm3,8mm组为(356.76 ±94.44)mm3,冷盐水组为(391.69±109.54)mm3;4mm组与8 mm组和冷盐水组的组间差异具有统计学意义(P<0.01),后两组组间差异无统计学意义.42处消融灶中有5处消融灶发生透壁性损伤.8处消融灶附近的冠脉发生病理性损伤,其中3处冠脉损伤明显.结论 应用8 mm及冷盐水灌注电极消融可使心肌损伤明显扩大,可以导致透壁性损伤,可以损伤邻近的冠脉.
目的 分析應用不同射頻導管電極消融房室環處心肌組織的損傷範圍及其鄰近冠狀動脈(冠脈)的損傷,評價其臨床應用的安全性.方法 取成年犬21隻,隨機分為3箇能量組:64℃、50 W、100 s,64℃、100 W、100 s,45℃、45 W、100 s;分彆應用4、8 mm電極及冷鹽水灌註電極進行消融(分彆簡稱4 mm組、8 mm組和冷鹽水組).每隻犬分彆消融左、右房室環各1處.實驗結束後以1/6π×長×寬×深計算損傷體積併對損傷的心肌及冠脈組織進行光學顯微鏡病理學分析.結果 觀察損傷深度:4mm組為(4.54±1.38)mm,8mm組為(7.18±1.72)mm,冷鹽水組為(7.99±1.77)mm.統計學分析:4 mm組與8mm組和冷鹽水組的組間相比,差異均具有統計學意義(P<0.01);後兩組組間的差異無統計學意義.損傷體積:4mm組為(191.34±74.52)mm3,8mm組為(356.76 ±94.44)mm3,冷鹽水組為(391.69±109.54)mm3;4mm組與8 mm組和冷鹽水組的組間差異具有統計學意義(P<0.01),後兩組組間差異無統計學意義.42處消融竈中有5處消融竈髮生透壁性損傷.8處消融竈附近的冠脈髮生病理性損傷,其中3處冠脈損傷明顯.結論 應用8 mm及冷鹽水灌註電極消融可使心肌損傷明顯擴大,可以導緻透壁性損傷,可以損傷鄰近的冠脈.
목적 분석응용불동사빈도관전겁소융방실배처심기조직적손상범위급기린근관상동맥(관맥)적손상,평개기림상응용적안전성.방법 취성년견21지,수궤분위3개능량조:64℃、50 W、100 s,64℃、100 W、100 s,45℃、45 W、100 s;분별응용4、8 mm전겁급랭염수관주전겁진행소융(분별간칭4 mm조、8 mm조화랭염수조).매지견분별소융좌、우방실배각1처.실험결속후이1/6π×장×관×심계산손상체적병대손상적심기급관맥조직진행광학현미경병이학분석.결과 관찰손상심도:4mm조위(4.54±1.38)mm,8mm조위(7.18±1.72)mm,랭염수조위(7.99±1.77)mm.통계학분석:4 mm조여8mm조화랭염수조적조간상비,차이균구유통계학의의(P<0.01);후량조조간적차이무통계학의의.손상체적:4mm조위(191.34±74.52)mm3,8mm조위(356.76 ±94.44)mm3,랭염수조위(391.69±109.54)mm3;4mm조여8 mm조화랭염수조적조간차이구유통계학의의(P<0.01),후량조조간차이무통계학의의.42처소융조중유5처소융조발생투벽성손상.8처소융조부근적관맥발생병이성손상,기중3처관맥손상명현.결론 응용8 mm급랭염수관주전겁소융가사심기손상명현확대,가이도치투벽성손상,가이손상린근적관맥.
Objective To analyze the extent of myocardium and coronary artery lesion post trioventricular ring radiofrequency catheter ablation with different tip catheters.Methods Twenty-one healthy dogs were randomly divided into 64℃/50 W/100 s,64 ℃/100 W/100 s,45 ℃/45 W/100 s groups and ablated by 4 mm tip catheter,8 mm tip catheter and irrigated tip catheter respectively.Left atrioventrieular ring and right atrioventricular ring ablation were performed in all dogs.After ablation,myocardium lesion volume was calculated as 1/6π × length × width × depth.Histological examinations were performed at the myocardium tissue at ablation sites.Results The lesion depths post 8 mm tip catheter ablation (7.18 ± 1.72) mm and irrigated tip catheter ablation (7.99 ± 1.77) mm were similar and significantly deeper than that post 4 mm tip catheter ablation (4.54 ± 1.38) ram,P<0.01.Similar results were found in terms of lesion volume [(356.76 ± 94.44) mm3 post 8 mm tip catheter ablation,(391.69 ± 109.54)mm3 post irrigated tip catheter ablation and (191.34±74.52) mm3 post 4 mm tip catheter ablation].Five (5/42,11.9%) transmural myocardium necrosis and 8 (8/42,19%) coronary artery lesions were observed post ablations.Conclusion The extents of post ablation myoeardium and coronary artery lesion were significantly higher induced by 8 nun tip catheter and irrigate tip catheter compared those by 4 mm tip catheter.
