目的 探究Cox-Ⅳ迷宫手术联合二尖瓣成形术治疗二尖瓣关闭不全合并心房颤动(atrial fibrillation,AF)的临床效果.方法 简单便利选取2022年1月—2023年1月蚌埠医科大学第一附属医院心脏外科收治的46例二尖瓣关闭不全合并AF患者作为研究对象,根据所行手术方式分为A组(18例,行二尖瓣成形术联合Cox-Ⅳ迷宫术)和B组(28例,行二尖瓣成形术),比较两组患者术中各项指标、术后AF复律、并发症、心功能指标.结果 A组手术时间、体外循环、阻断升主动脉时间均长于B组,术后24 h引流量大于B组,差异均有统计学意义(P均<0.05);两组住院时间和入住重症监护室(intensive care unit,ICU)时间对比,差异均无统计学意义(P均>0.05).术后1个月、3个月、6个月,A组AF复律均优于B组,差异均有统计学意义(P均<0.05).术后3个月,A组左室射血分数为(60.56±2.97)%,高于B组的(58.43±3.58)%,左房内径为(43.01±2.65)mm,低于B组的(44.97±1.87)mm,差异均有统计学意义(t=2.094,2.943;P均<0.05),两组左室舒张末径对比,差异无统计学意义(P>0.05).两组术后并发症总发生率对比,差异无统计学意义(P>0.05).结论 Cox-Ⅳ手术联合二尖瓣成形术治疗二尖瓣关闭不全合并AF的临床效果优于单纯二尖瓣成形术,可以改善术后AF转复率,提升术后心功能.
Analysis of Clinical Effect of Cox-Ⅳ Maze Operation Combined with Mi-tral Valvuloplasty on Mitral Regurgitation Complicated with Atrial Fibril-lation
Objective To explore the clinical effect of Cox-Ⅳ maze s operation combined with mitral valvuloplasty in the treatment of mitral regurgitation complicated with atrial fibrillation(AF).Methods From January 2022 to January 2023,46 patients with mitral regurgitation complicated with AF admitted to the Department of Cardiac Surgery in the First Affiliated Hospital of Bengbu Medical University were simple conveniently selected as the research objects.Ac-cording to the surgical methods,they were divided into group A(18 cases,mitral valvuloplasty combined with Cox-Ⅳ maze operation)and group B(28 cases,mitral valvuloplasty).The intraoperative indexes,postoperative AF cardiover-sion,complications and cardiac function indexes were compared between the two groups.Results The operation time,time of blocking the ascending aorta,main duration of obstruction in group A were longer than those in group B,and drainage volume 24 h after operation in group A was more than that in group B,and the differences were statistically sig-nificant(all P<0.05).There was no significant difference in hospitalization time and intensive care unit(ICU)stay be-tween the two groups(both P>0.05).Postoperative 1 month,3 months,6 months,AF cardioversion in group A was better than that in group B,and the differences were statistically significant(all P<0.05).3 months after operation,the left ven-tricular ejection fraction of group A was(60.56±2.97)％,which was higher than(58.43±3.58)％of group B,and the left atrial diameter was(43.01±2.65)mm,which was lower than(44.97±1.87)mm of group B,the differences were statisti-cally significant(t=2.094,2.943;both P<0.05);there was no significant difference in left ventricular end-diastolic diam-eter between the two groups(P>0.05).There was no significant difference in total postoperative complications rate be-tween the two groups(P>0.05).Conclusion The clinical effect of Cox-Ⅳ operation combined with mitral valvuloplasty in the treatment of mitral regurgitation complicated with AF is better than that of simple mitral valvuloplasty,which can improve the postoperative AF conversion rate and improve the postoperative cardiac function.
万方数据
维普
