射频消融术治疗特发性室性心律失常的疗效及安全性研究

摘要

Objective To observe the efficacy and safety of radiofrequency catheter ablation in the treatment of idiopathic ventricular arrhythmias.Methods 90 patients with idiopathic ventricular arrhythmias in our hospital from January 2013 to January 2015 were selected and randomly divided into two groups.Control group underwent propafenone treatment,while observation group underwent radiofrequency catheter ablation.Compared the therapeutic effect,ventricular function and structure improvement,and adverse reactions of two groups.Results The effective rate in observation group (95.56％) was significantly higher than that in control group (64.44％) (P＜0.05).The number of ventricular premature/24 h,the load level of ventricular premature significantly decreased after treatment in both two groups,total stroke volume/24 h significantly increased,the improvement degree of observation group was more significant than that of control group (P＜0.05).The levels of left ventricular function (LVEF,LVESD,and LVEDD) significantly improved in observation group after treatment (P＜0.05),and the levels of LVESD and LVEDD were significantly lower than those in control group (P＜0.05).The incidence of gastric adverse reactions of observation group (6.67％) was significantly lower than that of control group (26.67％) (P＜0.05),all mild,remission without special treatment or after symptomatic treatment.Conclusions The efficacy of radiofrequency catheter ablation for idiopathic ventricular arrhythmias is more accurate than propafenone,and has more obvious advantages in improving cardiac structure and function.The combination of the two can significantly reduce the drug dosage,and is well tolerated,can be the first choice for clinical treatment applied widely.%目的 观察射频消融术应用于特发性室性心律失常中的效果及安全性.方法 前瞻性选择2013年1月至2015年1月期间收治的90例特发性室性心律失常患者,采用随机抽签法将其分为两组,对照组给予普罗帕酮治疗,观察组行导管射频消融术,对比两组患者疗效、心室功能和结构改善情况及不良反应.结果 观察组有效率(95.56％)明显高于对照组的64.44％ (P＜0.05);两组患者治疗后室早次数/24 h和室早负荷水平较治疗前明显降低、总心搏量/24 h水平较治疗前明显增高(P＜0.05),观察组改善情况较对照组更为显著(P＜0.05),观察组治疗后左室功能(LVEF、LVESD、LVEDD)水平较治疗前明显改善(P＜0.05),且LVESD、LVEDD水平明显低于对照组(P＜0.05);观察组不良反应发生率(6.67％)明显低于对照组(26.67％)(P＜0.05),均较轻微,未经特殊处理或经对症处理后缓解.结论 导管射频消融术治疗特发性室性心律失常疗效较普罗帕酮更为确切,在改善患者的心脏结构和功能方面更具有明显优势,两者联合可明显减少药物应用剂量且耐受性好,可作为临床首选治疗方案广泛推广和应用.