目的 探讨外科射频消融改良迷宫对大左心室心脏瓣膜病合并心房颤动的效果评价及预后.方法 选择2016年1月至2018年2月于北京安贞医院心外科接受治疗的大左心室心脏瓣膜病合并心房颤动患者134例,随机分成对照组和研究组.对照组采取心脏瓣膜置换术治疗,研究组采取外科射频消融改良迷宫法治疗.比较两组患者的临床资料,手术射频消融时间和手术后恢复窦性心律的状况,患者在手术后半年内房颤持续时间的比较及术后的效果评价.结果 治疗后,研究组的手术射频消融时间以及手术后恢复窦性心律的状况均明显优于对照组(P＜0.05);治疗后,研究组患者在手术后半年内房颤持续的时间明显短于对照组(P＜0.05);研究组满意率为83.5%,对照组为44.7%,研究组患者的疗效满意率明显优于对照组(P＜0.05).结论 在治疗大左心室心脏瓣膜病合并心房颤动中,运用外科射频消融改良迷宫的方法效果理想,可在临床推广使用.%Objective To evaluate the efficacy and prognosis of modified labyrinth with surgical radiofrequency ablation in the treatment of great left ventricular valvular disease and atrial fibrillation. Methods From January 2016 to February 2018, 134 patients with large left ventricular valvular disease complicated with atrial fibrillation were randomly divided into control group and study group. The control group was treated with heart valve replacement, and the study group was treated with radiofrequency ablation modified maze method. The clinical data of the two groups were compared, the time of radiofrequency ablation and the recovery of sinus rhythm after operation, the duration of atrial fibrillation in the patients after the operation and the evaluation of postoperative effects were compared. Results After treatment, the radiofrequency ablation time of the study group and the recovery of sinus rhythm after surgery were significantly better than the control group (P＜0.05). The duration of atrial fibrillation in the study group was significantly shorter than that in the control group (P＜0.05). The satisfaction rate of the study group was 83.5%, and the satisfaction rate of the control group was 44.7%. The satisfaction rate of the treatment effect of the study group was significantly better than that of the control group (P＜0.05). Conclusion In the treatment of large left ventricular valvular heart disease with atrial fibrillation, the surgical treatment of surgical maize ablation to improve the maze is ideal, and should be further promoted clinically.
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