全胸腔镜下Box Lesion双极射频术治疗单纯性心房颤动的手术配合及护理_West China Medical Journal

Authors：

 吴雪霖 , 倪禾丰 ,  龚仁蓉

四川大学华西医院手术室（成都 610041）;

Corresponding author：

龚仁蓉, Email: gongrenrong@163.com

Keywords：

胸腔镜; 单纯性心房颤动; 护理

DOI：

10.7507/1002-0179.201600255

Video：

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目的总结全胸腔镜下Box Lesion 双极射频术治疗单纯性心房颤动（房颤）的手术配合方法及要点。方法对2011 年5 月－ 2012 年10 月收治的14 例行全胸腔镜Box Lesion 双极射频术治疗单纯性房颤患者的手术配合及护理方法进行总结，做到充分的术前准备，正确调节胸腔镜等仪器设备，放置最佳的手术体位，对手术步骤的熟悉，对胸腔镜、射频消融系统等特殊器械的了解和及时准确的传递等术中护理配合工作。结果 14 例患者在全胸腔镜下顺利完成手术，只需在双侧胸腔各开3 个长1 cm 左右的手术切口，平均手术时间（123±36）min，无术中并发症，无围手术期死亡，所有患者术后1 年随访，12 例（85.71%）患者恢复为窦性心律，2 例患者仍为房颤。结论术前充分准备和术中密切配合是提高全胸腔镜下Box Lesion 双极射频术效率、顺利完成手术的关键。

Citation： 吴雪霖, 倪禾丰, 龚仁蓉. 全胸腔镜下Box Lesion双极射频术治疗单纯性心房颤动的手术配合及护理. West China Medical Journal, 2016, 31(5): 946-948. doi: 10.7507/1002-0179.201600255 Copy

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1. 1 Zhang S. Atrial fibrillation in mainland China: epidemiology and current management[J]. Heart, 2009, 95(13):1052-1055.
2. Kopecky SL, Gersh BJ, Mcgoon MD, et al. The natural history of lone atrial fibrillation. A population-based study over three decades[J]. N Engl J Med, 1987, 317(11):669-674.
3. Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study)[J]. Am J Cardiol, 1994, 74(3):236-241.
4. Lévy S, Maarek M, Coumel P, et al. Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study. The College of French Cardiologists[J]. Circulation, 1999, 99(23):3028-35.
5. Cox JL, Schuessler RB, Boineau JP. The development of the Maze procedure for the treatment of atrial fibrillation[J]. Semin Thorac Cardiovasc Surg, 2000, 12(1):2-14.
6. Zuffada F, Saviano M, Pappone A, et al. Irrigated-tip magnetic catheter ablation of AF: a long-term prospective study in 130 patients[J]. Heart Rhythm, 2011, 8(1):8-15.
7. Wolf RK, Schneeberger EW, Osterday R, et al. Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation[J]. J Thorac Cardiovasc Surg, 2005, 130(130):797-802.
8. 李美清, 王晓丹, 廖冰野, 等. 手术室贵重器械的管理实践[J]. 中华护理杂志, 2010, 45(8): 768.
9. Kumagai K, Muraoka S, Mitsutake C, et al. A new approach for complete isolation of the posterior left atrium including pulmonary veins for atrial fibrillation[J]. J Cardiovasc Electrophysiol, 2007, 18(10): 1047-1052.
10. 周微微, 任卫东. 房颤发生机制研究进展[J]. 心脏杂志, 2003, 15(6): 558-562.
11. Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins[J]. N Engl J Med, 1998, 339(10): 659-666.
12. 石峻, 张本贵, 白志轩, 等. 全胸腔镜下Box Lesion双极射频治疗心房颤动[J]. 中国胸心血管外科临床杂志, 2011, 18(5): 433-435.
13. 陈秒, 江涛, 曾玲. 全胸腔镜下Box Lesion双极射频消融术治疗单纯性房颤围手术期护理[J]. 华西医学, 2012, 27(8): 1237-1239.

West China Medical Journal

全胸腔镜下Box Lesion双极射频术治疗单纯性心房颤动的手术配合及护理

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