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|本期目录/Table of Contents|

胸腔镜辅助与开胸肺叶切除术后房颤发生率和心率变异性的比较

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2018年第4期
页码:
453-457
栏目:
临床研究
出版日期:
2018-04-25

文章信息/Info

Title:
Comparation of the incidence of atrial fibrillation and the change of heart rate variabiliy between video-assisted pulmonary lobectomy and thoracotomy pulmonary lobectomy
作者:
何庚戌1; 要 彤2; 李方江2; 濮仁富1; 刘俊堂1; 赵 雷1; 蔡宝松1; 张 雁1; 周 峰1; 李海英1
(1.解放军第251医院胸心血管外科，河北 张家口 075000；2.北方学院第一附属医院心功能科，河北 张家口 075000)
Author(s):
HE Geng-xu1;  YAO Tong2;  LI Fang-jiang2;  PU Ren-fu1;  LIU Jun-tang1;  ZHAO Lei1;  CAI Bao-song1;  ZHANG Yan1;  ZHOU Feng1;  LI Hai-ying1
(1.Department of Thoracic and Cardiovascular Surgery, PLA 251 Hospital, Zhangjiakou 075000, Hebei, China; 2.Department of Electrocardiogram, First Affiliated Hospital of North College, Zhangjiakou 075000, Hebei, China)
关键词:
房颤; 胸腔镜辅助下肺叶切除术; 开胸手术; 心率变异性
Keywords:
atrial fibrillation;  video-assisted thoracic surgery;  thoracotomy;  heart rate variability
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 比较经胸腔镜与开胸肺叶切除手术后房颤发生率和术后心率变异性的差别。方法 60岁以上接受胸腔镜下肺叶切除术（胸腔镜组，n=112）与既往数据库中接受开胸肺叶切除术患者(开胸组，n=112)，在性别、年龄等基础临床资料与其相匹配患者，在术后经动态心电图监测96 h，分析房颤发生率以及术后不同时间段的心率变异性指标变化。结果 胸腔镜组术后发生房颤19例（发生率17.0%）、开胸组发生20例（17.9%），房颤发生时间均在术后24 h之后，两组之间无显著差异。两组术后整体心率变异性无显著差异。结论 胸腔镜手术并不能降低房颤的发生率，不同方式肺叶切除术对术后心率变异性无显著影响。
Abstract:
AIM To compare the incidence of atrial fibrillation and the change of heart variability after pulmonary lobectomy through video assisted thoracic surgery or thoracotomy, and to discuss the role of autonomic nerves in the mediation or modulation of atrial fibrillation after pulmonary lobectomy. METHODS Using a single institution database, 224 patients over 60 years of age with normal sinus rhythm were enrolled in the study. One experienced surgeon and an anesthetist carried out the surgery and anesthesia using the same procedure. The hearts were monitored using Holter for more than 96 hours and the new onset of atrial fibrillation was recorded and heart variability was analyzed at different time intervals. RESULTS 112 patients undergoing video-assisted thoracic surgery and 112 patients undergoing thoracotomy were eligible for the study. Atrial fibrillation occurred in 39 patients, and there was no difference between the two groups (VATS19/112, 16.9% and THOR 20/112, 17.9%, P=0.82). The heart variability showed no differences at different time intervals after the operation between the two groups. CONCLUSION Our investigation demonstrated that pulmonary lobectomy through video assisted thoracic surgery does not reduce postoperative atrial fibrillation.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2017-05-02.作者简介：何庚戌,主任医师，博士 Email：Hegengxu@yahoo.com.cn
更新日期/Last Update: 1900-01-01