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目的研究比较冷冻球囊消融术(CBA)与射频消融术(RFCA)治疗老年心房颤动患者的有效性和安全性。方法 80例经药物治疗失败或效果不理想的老年心房颤动患者,采用随机数字表法分为CBA组和RFCA组各40例。比较两组肺静脉隔离(PVI)成功率、手术时间、消融时间、冷冻最低温度及术后并发症发生情况。结果两组静脉PVI成功率无明显差异(P>0.05),CBA组各支静脉手术时间及消融世间均短于RFCA组,冷冻所需的最低温度低于RFCA组(均P<0.05)。两组术后均未出现脑血管意外,并发症发生率差异无统计学意义(P=0.274)。结论 CBA与RFCA用于治疗心房颤动的PVI效果并无太大差异,但CBA的优势在于缩短了手术时间及消融时间,因此极大改善了患者预后,有利于患者的长期恢复,有较高的安全性。虽然CBA临床操作难度与RFCA较低,但临床上还应根据患者情况、医院条件等选择采用CBA还是RFCA。
Objective To compare the effectiveness and safety of cryoablation ablation (CBA) and radiofrequency catheter ablation (RFCA) in the treatment of elderly patients with atrial fibrillation. Methods Eighty elderly patients with atrial fibrillation who failed or did not respond well were divided into CBA group and RFCA group by random number table. The success rate of pulmonary vein isolation (PVI), operation time, ablation time, minimum freezing temperature and postoperative complications were compared between the two groups. Results There was no significant difference in the success rate of PVI between the two groups (P> 0.05). The time of operation and ablation of each branch in CBA group were shorter than that of RFCA group. The minimum temperature required for freezing was lower than that of RFCA group (all P <0.05). No postoperative cerebrovascular accident occurred in both groups, with no significant difference in the incidence of complications (P = 0.274). Conclusion The efficacy of CBA and RFCA for the treatment of atrial fibrillation is not much different, but the advantage of CBA is that it can shorten the operation time and ablation time, thus greatly improving the prognosis of patients and long-term recovery of patients with higher safety. Although CBA clinical operation is less difficult and RFCA, but also clinical should be based on the patient’s condition, hospital conditions, etc. choose to use CBA or RFCA.