CartoUnivu与Carto3指导射频消融治疗快速心律失常的X线受照剂量的比较研究

发布时间：2019-04-24 04:52

【摘要】：目的:通过比较CartoUnivu系统与Carto3系统指导经导管射频消融治疗快速心律失常患者的X线受照剂量、X线曝光剂量,探讨CartoUnivu系统的应用优势。方法:连续入选2016年3月至2017年3月在广西医科大学第一附属医院住院为阵发性室上性心动过速(PSVT)及室性早搏和/或室性心动过速(PVC/VT)并行经导管射频消融治疗的快速心律失常患者,PSVT患者和PVC/VT患者按手术日期以1:1的比例各分为Carto Univu组(CU组)和Carto3组(C3组)。分别比较CU组和C3组的手术成功率、并发症发生率、手术时间、X线曝光时间、X线曝光剂量、患者4个部位X线受照剂量(甲状腺、左背部、会阴部、左上臂)、术者10个部位X线受照剂量(眼睛、甲状腺铅围脖内、甲状腺铅围脖外、左胸部铅衣内、左胸部铅衣外、会阴部铅衣内、会阴部铅衣外、左手小指、右手小指、左脚踝)的差异。结果:快速心律失常患者58例,其中,PSVT 42例(CU组21例,C3组21例),PVC/VT 16例(CU组8例,C3组8例),全部消融成功,无严重并发症发生。PSVT射频消融治疗,CU组与C3组比较,手术时间、X线曝光时间、X线曝光剂量、患者4个部位X线受照剂量、术者10个部位X线受照剂量均相似,无显著差异(P0.05)。PVC/VT射频消融治疗,CU组与C3组比较,手术时间、患者左背部X线受照剂量、术者7个部位(甲状腺铅围脖内、甲状腺铅围脖外、左胸部铅衣内、左胸部铅衣外、会阴部铅衣内、会阴部铅衣外、左手小指)X线受照剂量均无显著差异(P0.05),X线曝光时间、X线曝光剂量、患者3个部位(甲状腺、会阴部、左上臂)X线受照剂量、术者3个部位(眼睛、左手小指、左脚踝)X线受照剂量均明显减少(P0.05)。术后随访6±2个月两组均无复发临床快速心律失常。结论:应用CartoUnivu系统指导射频消融治疗PVC/VT优于Carto3系统,显著减少了X线曝光时间、X线曝光剂量、患者和术者X线受照剂量。
[Abstract]:Aim: to compare the X-ray irradiation dose and X-ray exposure dose of CartoUnivu system and Carto3 system in guiding radiofrequency catheter ablation for patients with tachyarrhythmia, and to explore the advantages of CartoUnivu system in application. Methods: from March 2016 to March 2017, patients with paroxysmal supraventricular tachycardia (PSVT), ventricular premature beat (PVC/VT) and / or ventricular tachycardia (PVC/VT) were admitted to the first affiliated Hospital of Guangxi Medical University. Patients with tachyarrhythmia treated with frequent ablation, Patients with PSVT and PVC/VT were divided into Carto Univu group (CU group) and Carto3 group (C3 group) at 1:1 according to the operation date. The successful rate of operation, complication rate, operation time, X-ray exposure dose and X-ray exposure dose (thyroid, left back, perineum, left upper arm) in CU group and C3 group were compared. X-ray irradiation dose (eyes, thyroid lead neck, left chest lead coat, perineal lead coat, left small finger, right hand little finger) were exposed to X-ray at 10 sites (eyes, thyroid lead neck, left chest lead coat, perineal lead coat, left hand small finger, right hand small finger). The difference between the left ankle and the left ankle. Results: among 58 patients with tachyarrhythmia, 42 were PSVT (CU 21, C3 21), 16 PVC/VT (CU 8, C3 8). Compared with C3 group, the operation time, X-ray exposure dose, X-ray exposure dose at 4 sites, and X-ray exposure dose at 10 sites were similar in CU group and C3 group, and there was no significant difference between the two groups (P0.05). Compared with C3 group, the time of operation, the dose of X-ray irradiation on the left back of the CU group were compared with those of the C3 group. The 7 sites of the patients (thyroid lead neck, left chest, perineum and perineum) were compared with those in the C3 group, the operation time and the dose of X-ray irradiation on the left back of the patient were compared. There was no significant difference in X-ray dose (P0.05), X-ray exposure time, X-ray exposure dose, X-ray exposure dose in 3 sites (thyroid, perineum, left upper arm) of the patients, and 3 sites (eyes, eyes) of the patients, but no significant difference was found in the X-ray exposure dose of the left small finger (P0.05). The dose of X-ray irradiation of left small finger and left ankle was significantly decreased (P0.05). After 6 卤2 months follow-up, there was no recurrence of tachyarrhythmia in both groups. Conclusion: the radiofrequency ablation with CartoUnivu system is superior to Carto3 system in the treatment of PVC/VT, and the time of X-ray exposure, the dose of X-ray exposure of the patients and the surgical patients are significantly reduced.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.7

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