应用实时三维超声技术评价房颤患者射频消融术前后左心房功能改变

发布时间：2018-03-01 13:32

本文关键词： 实时三维超声心动图心房颤动射频消融术左心房功能　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本文主要是采用三维超声心动图技术(RT-3DE)对经射频消融术(RFCA)治疗的阵发性房颤患者左房容积动态变化情况进行实时跟踪分析,评价其手术后效果。方法:研究对象:2014年10月至20016年10月之间,40位来我院进行治疗阵发性房颤疾病的患者;治疗手段:射频消融手术(RFCA);手术开始之前的3天以及治疗结束的3天后,1个月后,3及6个月后采用超声心动图技术进行复诊检查。手术后,对已治愈患者进行追踪观察,并行四次超声心动图检查复查,以了解其病患处的变化情况。比较分析患者消融手术(RFCA)前后各个相应时间点的左心房相关指标改变情况。患者检查时均为窦性心律。复诊主要是以常规测量及RT-3DE测量为主,其包含了:左心房室的相应功能指标,左心房最小、最大的容积(LAVmin、LAVmax),左心房主动、被动的排空分数(LAAEF、LAPEF),左心房收缩前的容积(LAVp)等等。其中测量的各数据分别反映了:左心房的存储、辅泵功能以及左心室的舒张、收缩功能。最后,计算反应左心房整体功能的左心房功能指数(LAFI)。结果:从测量的各项指标中,我们可以看出手术前后的显著差异,手术后3天时间内LAFI及A峰值、Aa显著下降,前者调查对象之间没有显著的差异,不具有统计学意义(p0.05),而后者的调查对象之间的差异显著,具有统计学意义(p0.05);手术1个月后,患者的心室、心房各项生理功能明显改善,差异非常显著,具有统计学意义(p0.05);术后3个月LAFI、LAAEF、LAPEF、LAEF、A峰及Aa均明显升高(P0.05),LAD及左心房容积明显减小,差异均显著有统计学意义(P0.05);术后6个月除上述变化外,S峰亦明显增高,D峰明显降低差异显著(P0.05)。结论:采用经导管射频消融术(RFCA)治愈的患者,在手术结束的三天时间内,其左心房的功能出现下降的现象;经过一个月时间后,左心房的功能慢慢开始恢复,处于一个缓慢的上升期;手术后3到6个月期间,患者的左心房辅泵、管道功能都得到了提高;采用三维超声心动图的技术可以准确、快速的监测到术后患者心房的动态变化情况。
[Abstract]:Objective: to analyze the dynamic changes of left atrial volume in patients with paroxysmal atrial fibrillation treated by radiofrequency ablation (RFCA) with three dimensional echocardiography (RT-3DED). Methods: from October 2014 to October, 40 patients came to our hospital to treat paroxysmal atrial fibrillation. Methods of treatment: radiofrequency catheter ablation (RFCA) was performed 3 days before the operation and 3 days after the end of the operation. Echocardiography was used to follow up the cured patients 3 and 6 months later, and the patients who had been cured were followed up and observed after the operation. Four echocardiographic examinations were performed. In order to understand the changes of patients, the changes of left atrium related indexes before and after ablation operation were compared and analyzed. The patients were all sinus rhythm at the time of examination. The main methods of re-diagnosis were routine measurement and RT-3DE measurement. It includes the corresponding functional indexes of the left atrium, the smallest left atrium, the largest volume of LAVmin LAVmaxa, the active left atrium, the passive emptying fraction of LAAEFN LAPEFN, the volume of left atrium before contraction and so on. The measured data reflect the storage of the left atrium, respectively. Auxiliary pump function and left ventricular diastolic and systolic function. Finally, the left atrial function index (Lafi), which reflects the global function of the left atrium, was calculated. Results: from the measurements, we can see the significant difference before and after the operation. During the 3 days after operation, LAFI and A peak value Aa decreased significantly. There was no significant difference between the former and the latter, but the difference between the latter was significant (P 0.05), and one month after the operation, there was no significant difference between the two groups, and one month after the operation, there was no significant difference between the two groups. The ventricular and atrial physiological functions of the patients were significantly improved with significant difference (P 0.05), and the Lafi / LAAEFA / LAPEFA peak and a were significantly increased at 3 months after operation, and the volumes of left atrium and left atrium decreased significantly. In addition to the above changes, the S peak also increased significantly at 6 months after operation. The difference was significant (P 0.05). Conclusion: the patients cured by radiofrequency catheter ablation (RFCA) were cured within 3 days after operation. The function of the left atrium declined; after a month, the function of the left atrium slowly began to recover, in a slow upward period, and during the period of 3 to 6 months after the operation, the patient's left atrium pump, Using three-dimensional echocardiography can accurately and quickly monitor the dynamic changes of the patients' atrium after operation.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.1;R541.75

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