中国医药
中國醫藥
중국의약
CHINA MEDICINE
2011年
11期
1302-1304
,共3页
心房颤动%窦性冲动疏导术%多子波折返激动%室上性心动过速
心房顫動%竇性遲動疏導術%多子波摺返激動%室上性心動過速
심방전동%두성충동소도술%다자파절반격동%실상성심동과속
Atrial fibrillation%Sinus impulse dredging procedure%Multiple wavelets%Supraventricular tachycardia
目的 观察窦性冲动疏导术治疗心房颤动的长期疗效.方法 1996年5月至2002年6月,9例患者接受了窦性冲动疏导术,消除多子波折返激动.其中7例同时进行二尖瓣置换.术后对9例患者进行不定期随访,随访过程中,患者接受心电图,彩色超声心动图检测.结果 2例于随访l后及1.5年后失访,其他7例患者随访7 ～13年.术后1年内心功能Ⅰ级5例,Ⅱ级4例；窦性心律2例,类窦性心律7例；Ⅲ度AV-B并发症1例,心肌病进展1例,肾功能不全1例；心房A/E峰为0.3者2例,0.4者4例,0.5者2例,0.6者1例.有6例于术后1～2周内先后出现过早搏、阵发性室上性心动过速等心律失常,未服用抗心律失常药自行恢复规律的心律.结论 窦性冲动疏导术是一种可以有效消除心房多子波折返激动的术式,消除了多子波折返激动就可以消除心房颤动.但是得到的却是一种永久性的室上心律.如果对这种单一的室上心律起搏点进行消融,失去了异位起搏点后可以得到的应该是窦性心律.
目的 觀察竇性遲動疏導術治療心房顫動的長期療效.方法 1996年5月至2002年6月,9例患者接受瞭竇性遲動疏導術,消除多子波摺返激動.其中7例同時進行二尖瓣置換.術後對9例患者進行不定期隨訪,隨訪過程中,患者接受心電圖,綵色超聲心動圖檢測.結果 2例于隨訪l後及1.5年後失訪,其他7例患者隨訪7 ～13年.術後1年內心功能Ⅰ級5例,Ⅱ級4例；竇性心律2例,類竇性心律7例；Ⅲ度AV-B併髮癥1例,心肌病進展1例,腎功能不全1例；心房A/E峰為0.3者2例,0.4者4例,0.5者2例,0.6者1例.有6例于術後1～2週內先後齣現過早搏、陣髮性室上性心動過速等心律失常,未服用抗心律失常藥自行恢複規律的心律.結論 竇性遲動疏導術是一種可以有效消除心房多子波摺返激動的術式,消除瞭多子波摺返激動就可以消除心房顫動.但是得到的卻是一種永久性的室上心律.如果對這種單一的室上心律起搏點進行消融,失去瞭異位起搏點後可以得到的應該是竇性心律.
목적 관찰두성충동소도술치료심방전동적장기료효.방법 1996년5월지2002년6월,9례환자접수료두성충동소도술,소제다자파절반격동.기중7례동시진행이첨판치환.술후대9례환자진행불정기수방,수방과정중,환자접수심전도,채색초성심동도검측.결과 2례우수방l후급1.5년후실방,기타7례환자수방7 ～13년.술후1년내심공능Ⅰ급5례,Ⅱ급4례；두성심률2례,류두성심률7례；Ⅲ도AV-B병발증1례,심기병진전1례,신공능불전1례；심방A/E봉위0.3자2례,0.4자4례,0.5자2례,0.6자1례.유6례우술후1～2주내선후출현과조박、진발성실상성심동과속등심률실상,미복용항심률실상약자행회복규률적심률.결론 두성충동소도술시일충가이유효소제심방다자파절반격동적술식,소제료다자파절반격동취가이소제심방전동.단시득도적각시일충영구성적실상심률.여과대저충단일적실상심률기박점진행소융,실거료이위기박점후가이득도적응해시두성심률.
Objective To analyze the termination of the multiple wavelets to stop the atrial fibrillation (AF).Methods Nine patients accepted sinus impulse dredging procedure.among them 7 were mitral valve replacement (MVR).These patients were followed up for 1-13 years by electrocardiogram and echocardiography for the heart rhythm and kick function of the left atrium atrial fibrillation.Results Seven patients were followed up for 7-13 years.Among all patients,there were cardiac function level Ⅰ in 5 cases,level Ⅱ in 4 cases,sinus rhythm in 2 cases,class sinus rhythm in 7 cases,AV-B Complication levelⅢ in 1 case,cardiomyopathy progress in 1 case and renal insufficiency in 1 case.The value of atrial A/E peak was 0.3 in 2 cases,0.4 in 4 cases,0.5 in 2 cases and 0.6 in 1 case.There were premature or paroxysmal supraventricular tachycardia of the number 2,4,6,7,8,9 patients in 1 ～ 2 weeks.Conclusions Sinus impulse dredging procedure is an effective operation to terminate the multiple wavelets.If the multiple wavelets are terminated,the atrial fibrillation will be cured.But the rhythm is permanent super ventricular rhythm after sinus impulse dredging procedure.There may be arrhythmia originating from the same bursting point.
