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[目的]评价单导管射频消融治疗顽固性室性早搏的方法以及消融后对室性早搏患者生活质量的影响。[方法]人选52例顽固性室早患者,男性28例,女性24例,年龄14~62岁,平均(36±14)岁。室早的病程为6个月~28年,其中42例右室流出道起源室早,3例左室流出道起源室早,5例左后分支起源室早,2例右室前壁起源室早。室早心内电生理标测采用单导管起搏标测和激动标测相结合的方法选择靶点消融;在术前、术后分别填写SF-36调查表,观察术前、术后患者一般健康状况(GH)、生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、精力(VT)、社会功能(SF)、情感职能(RE)、精神健康指标(MH),并进行评分、统计分析。[结果]消融术成功40例,好转7例,失败5例,有效47例(约占总数的90.4%)。平均手术时间(1.0±0.8)h,X线暴露时间(12.6±6.4)min,平均放电次数(4.8±2.0)次,阻抗80~110欧母。所有患者随访术后1周至1年内,患者术中、术后未发生与射频消融有关的严重并发症,患者整体的生活质量有明显提高。[结论]单导管射频消融治疗顽固性室性早搏安全,有效,并能显著改善患者的生活质量。
[Objective] To evaluate the effect of single-catheter radiofrequency catheter ablation on refractory ventricular premature beats and the effect of post-ablation on the quality of life in patients with premature ventricular contractions. [Methods] Fifty-two patients with refractory early ventricular disease were selected, including 28 males and 24 females, aged from 14 to 62 years with an average of (36 ± 14) years. Early as early as 6 months to 28 years, of which 42 cases of early right ventricular outflow tract as early as three cases of left ventricular outflow tract as early as room, five cases of left posterior branch of the room early, two cases of right ventricular anterior chamber early. Ventricular electrophysiological mapping in early ventricular catheterization using single catheterization and excitement mapping method to select the target ablation; preoperative and postoperative were filled in SF-36 questionnaire to observe the preoperative and postoperative patients in general (GH), physical function (PF), physiology function (RP), body pain (BP), energy (VT), social function (SF), emotional function (RE) and mental health index Score, statistical analysis. [Results] 40 cases were successful in ablation, 7 cases were improved, 5 cases failed and 47 cases were effective (about 90.4% of the total). The average operation time was 1.0 ± 0.8 h, the time of X-ray exposure was 12.6 ± 6.4 min, the average number of discharges was 4.8 ± 2.0 times and the impedance was 80-110 ohms. All patients were followed up within 1 week to 1 year after surgery, the patient did not occur during and after radiofrequency ablation associated with serious complications, the overall quality of life of patients improved significantly. [Conclusion] Single catheter radiofrequency catheter ablation is safe and effective in refractory premature ventricular contractions and can significantly improve the quality of life of patients.