本文關(guān)鍵詞： 實(shí)時(shí)三維超聲心動(dòng)圖 心房顫動(dòng) 射頻消融術(shù) 左心房功能　出處：《鄭州大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:本文主要是采用三維超聲心動(dòng)圖技術(shù)(RT-3DE)對(duì)經(jīng)射頻消融術(shù)(RFCA)治療的陣發(fā)性房顫患者左房容積動(dòng)態(tài)變化情況進(jìn)行實(shí)時(shí)跟蹤分析,評(píng)價(jià)其手術(shù)后效果。方法:研究對(duì)象:2014年10月至20016年10月之間,40位來(lái)我院進(jìn)行治療陣發(fā)性房顫疾病的患者;治療手段:射頻消融手術(shù)(RFCA);手術(shù)開(kāi)始之前的3天以及治療結(jié)束的3天后,1個(gè)月后,3及6個(gè)月后采用超聲心動(dòng)圖技術(shù)進(jìn)行復(fù)診檢查。手術(shù)后,對(duì)已治愈患者進(jìn)行追蹤觀察,并行四次超聲心動(dòng)圖檢查復(fù)查,以了解其病患處的變化情況。比較分析患者消融手術(shù)(RFCA)前后各個(gè)相應(yīng)時(shí)間點(diǎn)的左心房相關(guān)指標(biāo)改變情況。患者檢查時(shí)均為竇性心律。復(fù)診主要是以常規(guī)測(cè)量及RT-3DE測(cè)量為主,其包含了:左心房室的相應(yīng)功能指標(biāo),左心房最小、最大的容積(LAVmin、LAVmax),左心房主動(dòng)、被動(dòng)的排空分?jǐn)?shù)(LAAEF、LAPEF),左心房收縮前的容積(LAVp)等等。其中測(cè)量的各數(shù)據(jù)分別反映了:左心房的存儲(chǔ)、輔泵功能以及左心室的舒張、收縮功能。最后,計(jì)算反應(yīng)左心房整體功能的左心房功能指數(shù)(LAFI)。結(jié)果:從測(cè)量的各項(xiàng)指標(biāo)中,我們可以看出手術(shù)前后的顯著差異,手術(shù)后3天時(shí)間內(nèi)LAFI及A峰值、Aa顯著下降,前者調(diào)查對(duì)象之間沒(méi)有顯著的差異,不具有統(tǒng)計(jì)學(xué)意義(p0.05),而后者的調(diào)查對(duì)象之間的差異顯著,具有統(tǒng)計(jì)學(xué)意義(p0.05);手術(shù)1個(gè)月后,患者的心室、心房各項(xiàng)生理功能明顯改善,差異非常顯著,具有統(tǒng)計(jì)學(xué)意義(p0.05);術(shù)后3個(gè)月LAFI、LAAEF、LAPEF、LAEF、A峰及Aa均明顯升高(P0.05),LAD及左心房容積明顯減小,差異均顯著有統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后6個(gè)月除上述變化外,S峰亦明顯增高,D峰明顯降低差異顯著(P0.05)。結(jié)論:采用經(jīng)導(dǎo)管射頻消融術(shù)(RFCA)治愈的患者,在手術(shù)結(jié)束的三天時(shí)間內(nèi),其左心房的功能出現(xiàn)下降的現(xiàn)象;經(jīng)過(guò)一個(gè)月時(shí)間后,左心房的功能慢慢開(kāi)始恢復(fù),處于一個(gè)緩慢的上升期;手術(shù)后3到6個(gè)月期間,患者的左心房輔泵、管道功能都得到了提高;采用三維超聲心動(dòng)圖的技術(shù)可以準(zhǔn)確、快速的監(jiān)測(cè)到術(shù)后患者心房的動(dòng)態(tài)變化情況。
[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.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R445.1;R541.75

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本文編號(hào)：1552182