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目的 评价Cox迷宫Ⅲ型手术治疗心房颤动的远期效果。方法 回顾性总结采用Cox迷宫Ⅲ手术治疗风湿性二尖瓣病变所致房颤的远期疗效。男 2 0例 ,女 14例 ,年龄 (40 .32± 6 .37)岁 ,风湿病史 15年以上 ,心房颤动 (房颤 )病史 2～ 8年 (4.2 1± 1.75 )年。术前心功能Ⅲ～Ⅳ级。同期均行二尖瓣置换术 ,附加三尖瓣成形术 18例 ,清除左房血栓 2例。结果 本组无手术死亡。随访 35～ 6 4个月 ,平均 39.4个月。术后房颤均消失 ,有 1例为结性心律。窦性心律占 97.0 8% (33 34) ,在作最大体力活动时均无窦性迟钝现明 ,无一例需起搏器 ,均有心房收缩功能 ;术后 1年心功能Ⅰ级占 94 .12 % (32 34) ,Ⅱ级 5 .88% (2 34) ;无血栓栓塞并发症 ;晚期死亡 1例 ,死于术后第三年。结论 迷宫Ⅲ型手术治疗风湿性二尖瓣病变所致房颤安全有效 ,能消除房颤 ,恢复心房收缩 ,远期疗效确切。
Objective To evaluate the long-term effect of Cox maze type Ⅲ surgery on atrial fibrillation. Methods We retrospectively reviewed the long-term efficacy of Cox maze III in the treatment of atrial fibrillation caused by rheumatic mitral valve disease. There were 20 males and 14 females, with a mean age of (40.32 ± 6.37) years, rheumatic history of more than 15 years and atrial fibrillation history of 2 to 8 years (4.2 ± 1.75) years. Preoperative cardiac function Ⅲ ~ Ⅳ level. Mitral valve replacement surgery were performed during the same period, with additional tricuspid annuloplasty in 18 cases and left atrial thrombus in 2 cases. Results This group had no operative death. Follow-up 35 ~ 64 months, an average of 39.4 months. Postoperative atrial fibrillation were disappeared, 1 case of nodal rhythm. The sinus rhythm accounted for 97.0 8% (33 34). No sinus retardation was found during the maximal physical activity. No patient required pacemaker, all had atrial systolic function. 12% (32 34), grade II 5.88% (2 34); no thromboembolic complications; 1 died of advanced stage, died of the third year after surgery. Conclusion Maze Ⅲ type of surgery for rheumatic mitral valve disease caused by atrial fibrillation safe and effective, can eliminate atrial fibrillation, atrial contraction recovery, long-term curative effect is exact.