室上性心动过速导管射频消融和开胸手术临床与经济效应比较

作者比较了17与19例分别接受过开胸与导管射频消融术(RFCA)治疗阵发性室上性心动过速(PSVT)患者的临床效应、投入的人、财、物等参数.结果:RFCA能有效治疗包括房室结(AVNRT)与房室(AVRT)折返的PSVT患者;对于AVRT,二者成功率、复发率与并发症发生率无显著差异(P>0.05);与开胸手术比较,RFCA操作时间短,参加人数少,住院天数包括术前准备与术后恢复以及术后陪床天数均明显缩短,P<0.05;而二者住院费无显著差异(P>0.05),所需最低设备投入费大致相等.提示RFCA治疗PSVT具有适应证宽、快捷、高效、安全、损伤小,易被患者接受等优点.但与开胸术比较,RFCA显著增加(P<0.05)的X线曝光量则提示:开展RFCA,需有充分的医患防护意识和良好的防护设备.

Comparison of Clinical and Economic Effects between Catheter Radoifrequency Current Ablation and Openheart Operation for Chinese Patients with Paroxysmal Supraventricular Tachycardia

Clinical effects and people, money and equipment for treatment of 17 and 19 patients with paroxysmal supraventricular tachycardia (PSVT) who received open-heart operation (OHO)and catheter radiofrequency cur-rent ablation (RFCA), respectively, were compared. The results showed that RFCA could cure the patients with PSVT which included both atrioventricular nodal reen-trant tachycardia (AVNRT) and atrioventricular reen-trant tachycardia (AVRT). There were not remarkable difference (p>0. 05) in rate of success, recurrence and complication between RFCA and OHO for the patients with AVRT. Medical workers were fewer, operation, du-ration, hospital days (including days of pre-operation preparation and post-operation recovery) and days of looking after the patients in RFCA were shorter than those in OHO,p<0. 05. There was no difference in the total hospital fee and least money invested for equipment between RFCA and OHO. These suggested RFCA was suitable for both AVNRT and AVRT,and simple effec-tive, safe, also no much injury for the patients. However, much longer X-ray exposure time in RFCA suggested both concept and equipment of preventing medical per-sonnel and patients from X-ray were very necessary.