孙鸣宇,王祖禄,梁明,杨桂棠,金志清,陈蕾,郑金烁,曹立仁

• 1:北部战区总医院全军心血管病研究所心内科

摘要(Abstract)：

目的总结非深度镇静下冷冻球囊消融(CBA)治疗心房颤动(房颤)的疗效及安全性。方法回顾性分析北部战区总医院2017年1-12月行CBA的259例房颤患者,其中深度镇静组应用咪达唑仑及枸橼酸芬太尼深度镇静156例,非深度镇静组103例。结果深度镇静组患者达到理想深度镇静效果的患者112例(71.8%),从给药到深度镇静状态时间(17.3±5.9)min。两组患者术中平均收缩压比较,差异无统计学意义(P>0.05)。深度镇静组患者术中平均舒张压[(83.9±13.8)mmHg比(88.0±14.5)mmHg,P=0.035,1mmHg=0.133kPa]及平均心率[(70.9±9.8)次/分比(77.0±14.7)次/分,P=0.026]均低于非深度镇静组,差异均有统计学意义。两组患者迷走神经反射发生率及术中咳嗽,恶心、呕吐,疼痛(包括头痛、胸痛或头痛合并胸痛)发生率比较,差异均无统计学意义(均P>0.05)。深度镇静组肢体移动发生率高于非深度镇静组(8.3%比1.9%,P=0.031)。两组患者手术时间及曝光量比较,差异均无统计学意义(均P>0.05)。结论 CBA治疗房颤时,术中肺静脉电位隔离均成功。非深度镇静并未增加患者疼痛发生率,清醒患者可将疼痛刺激及不适症状及时反馈给术者,有利于降低并发症的发生率。

关键词(KeyWords)： 冷冻球囊导管消融;心房颤动;咪达唑仑;芬太尼

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划(2016YFC0900904)

作者(Author): 孙鸣宇,王祖禄,梁明,杨桂棠,金志清,陈蕾,郑金烁,曹立仁

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