冷冻球囊导管消融术治疗房颤

2014-03-19 通讯员 张丹娜 医学论坛网

近期,广东省人民医院心内科成功应用冷冻球囊导管消融新技术治疗心房颤动(房颤),截止本周,已有7例房颤患者接受了该手术,其中2例于去年12月完成,术后已经超过3个月,未再服用任何药物情况下,无房颤发生,生活质量大为提高。据悉,广东省人民医院是华南地区首家开展该种手术的医院。房颤是最常见的心律失常之一,房颤患者数量庞大。在中国,成年人房颤患病率每10万约770人,约有800万房颤患者。房颤是缺血性脑卒

近期,广东省人民医院心内科成功应用冷冻球囊导管消融新技术治疗心房颤动(房颤),截止本周,已有7例房颤患者接受了该手术,其中2例于去年12月完成,术后已经超过3个月,未再服用任何药物情况下,无房颤发生,生活质量大为提高。据悉,广东省人民医院是华南地区首家开展该种手术的医院。

房颤是最常见的心律失常之一,房颤患者数量庞大。在中国,成年人房颤患病率每10万约770人,约有800万房颤患者。房颤是缺血性脑卒中和死亡的主要危险因素,与普通人群相比,房颤患者发生脑卒中的风险增高5倍,20%的缺血性脑卒中与房颤相关。房颤所致卒中的致死率、致残率更高,与其他原因所致卒中相比,房颤患者发生卒中后死亡率升高2倍,严重致残比例增加50%。传统的非药物治疗房颤手段主要是导管射频消融。

导管消融手术治疗房颤是采取高频电流局部加热的方式逐点消融,隔离两侧肺静脉传导通常需要在复杂的三维指导下消融几十个点,耗时长,手术操作复杂。而冷冻球囊导管消融新技术的能源和射频的完成相反,其原理是将装有液态制冷剂的球囊用导管引入目标消融部位,利用制冷剂降低病变部位温度,“冷死”其细胞组织。

同时还减少心内膜表面的损害和附壁血栓的形成,降低术中和术后脑血栓的危险。而且,冷冻球囊的设计,可以使得病变组织的杀灭更均匀,更彻底,提高远期的成功率,有助于减少复发。国外大量临床数据显示,和传统射频热消融相比,冷冻消融更易于医生操作,不仅缩短了手术时间,而且治疗有效性高,术中冷冻温度监测功能增加安全性,同时降低患者疼痛。

心内科方咸宏主任医师介绍,冷冻球囊导管消融手术属微创介入治疗,不需要开刀,仅将很细的导管通过静脉穿刺送到心房。整个手术过程病人不需要镇静,无痛苦,耐受性好。方咸宏提醒说,阵发性房颤的总体药物疗效欠佳,多项研究表明,阵发性房颤越早期治疗,患者的获益越大,更可以避免发展到持续性房颤。

冷冻球囊消融导管术具有易操作,手术时间短,病人痛苦少的特点,在欧美等25个国家和地区的600个医疗中心广泛应用,积累了超过7万个病例的临床使用经验,是一项成熟的治疗房颤新技术。


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    2014-03-21 花花1366
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