CAJ | 학술논문

目的：评估迷宫手术对房间隔缺损合并心房颤动（房颤）患者的治疗效果。方法986例40岁以上房间隔缺损术患者，根据术前是否存在房颤分为三组。A组为不合并房颤患者（窦性心律），共619例；B组为合并房颤并同期进行迷宫手术患者，共269例；C组为合并房颤未同期处理患者，共98例。观察三组患者术后并发症以及恢复情况。结果C组患者预后较差，机械通气时间更长，肺炎发生率更高，入住重症监护病房（ICU）时间及住院时间均长于其他两组。经过倾向性匹配后，A组与B组在术后神经系统并发症、肾衰竭、肺炎发生率、机械通气时间、死亡率等方面比较，差异均无统计学意义（P＞0.05）。结论合并房颤的房间隔缺损患者同期进行迷宫手术并不增加围术期死亡率，迷宫手术后恢复窦性心律比例较高，效果满意，应积极在房间隔缺损矫治手术中同期进行。
목적：평고미궁수술대방간격결손합병심방전동（방전）환자적치료효과。방법986례40세이상방간격결손술환자，근거술전시부존재방전분위삼조。A조위불합병방전환자（두성심률），공619례；B조위합병방전병동기진행미궁수술환자，공269례；C조위합병방전미동기처리환자，공98례。관찰삼조환자술후병발증이급회복정황。결과C조환자예후교차，궤계통기시간경장，폐염발생솔경고，입주중증감호병방（ICU）시간급주원시간균장우기타량조。경과경향성필배후，A조여B조재술후신경계통병발증、신쇠갈、폐염발생솔、궤계통기시간、사망솔등방면비교，차이균무통계학의의（P＞0.05）。결론합병방전적방간격결손환자동기진행미궁수술병불증가위술기사망솔，미궁수술후회복두성심률비례교고，효과만의，응적겁재방간격결손교치수술중동기진행。
Objective To assess the effect of the Cox-maze procedure for adult patients with atrial septal defect (ASD) combined with atrial fibrillation(AF). Methods A total of 986 patients with ASD above 40 years old were divided into three groups according to presence of AF before opeation. The group A was without AF (sinus rhythm)(n=619);the group B was com-bined with AF and underwent Cox-maze procedure(n=269);the group C was combined with AF but without Cox-maze procedure (n=98). The postoperative complications and recovery conditon of the three groups were observed. Results Compared with the group A and group B,the group C had poorer prognosis,longer duration of mechanical ventilation,higher incidence rate of pneu-monia,longer ICU time and hospital stays. After propensity score matching,there were no statistically significant differences be-tween the group A and group B on postoperative neurological complictions,rennal failure,incidence rate of pneumonia,duration of mechanical ventilation and death rate(P>0.05). Conclusion To the patients with ASD and AF,Cox-maze will not increase the death rate during perioperative period ,it has higher proportion of sinus rhythm after operation with satisfactory effect ,so it should be employed in the teatment of ASD actively.