20例房颤射频消融术的手术配合及护理

目的对房颤射频消融术的手术配合进行观察和探讨。方法 2011年1月-2014年1月我院应用射频消融术治疗房颤20例,同时予以术前、术中及术后有效的护理配合。20例房颤患者中男14例,女6例,年龄35-78岁,平均（47.1±3.4）岁,房颤病史3-20年,平均（18.1±6.5）年。其中16例为阵发性房颤,4例为持续性房颤。结果本组20例行射频消融术患者中无一例死亡,均完成肺静脉电隔离;手术时间2.5-3.0 h。术中2例出现心动过缓-低血压反应,经处理停止操作后恢复。随访6-12个月,共2例（10%）近期（术后3个月内）出现房早、房速及房扑等房性心律失常,2例（10%）远期（术后3个月后）复发房颤持续时间〉30 s;均经过胺碘酮等抗心律失常药物处理后主观症状较术前明显减轻,心功能明显改善;远期复发患者经沟通症状改善,未接受二次射频消融治疗。结论射频消融术可明显提高心房颤动患者的生活质量,但术后易出现严重的并发症,对房颤射频消融术患者做好心理护理、术前准备、术后护理、重视并发症的观察与护理,能减轻患者的生理、心理负担,早日康复。

The operation and nursing of 20 patients with atrial fibrillation radiofrequency ablation

Objective To investigate the right atrial fibrillation radiofrequency ablation operation. Methods From 2011 January to January 2014, 20 cases patients in our hospital application of radiofrequency ablation of atrial fibrillation were selected, also combined with effective nursing before during and after the operation. 20 cases of atrial fibrillation in patients with male 14 cases, female 6 cases, aged from 35 to 78 years old, average（47.1±3.4） years old, AF 3 to 20 years, averaged（18.1±6.5） years. 16 cases of paroxysmal atrial fibrillation, 4 patients with persistent atrial fibrillation.Results No deaths in 20 cases with radiofrequency ablation patients, completed the electrical isolation of pulmonary veins; operation time was 2.5 to 3.0 hours. 2 patients appeared heartbeat bradycardia and hypotension, after stop operating,two patients recoveried. All the patients were followed up for 6 to 12 months, a total of 2 cases（10%） recent（3postoperative months） real early happened atrial tachycardia and atrial flutter atrial arrhythmia, 2 cases（10%） and longterm（3 months after surgery） of recurrent AF duration greater than 30 s; After the antiarrhythmic amiodarone etc. arrhythmia after drug treatment, the subjective symptoms significantly reduced, the cardiac function significantly improved after communication; improve symptoms in patients with late relapse, did not accept the two times of RFA treatment. Conclusion Radiofrequency ablation can significantly improve the quality of life, but can happen more complications postoperative, so the atrial fibrillation radiofrequency ablation in patients with psychological nursing, preoperative preparation, postoperative nursing, pay attention to the observation and nursing of complications, can lighten physiology, the psychological burden of patients, and early rehabilitation.