本文選題：心房顫動(dòng) + 經(jīng)食道超聲�。� 參考：《廣西醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的：本研究旨在探討心房顫動(dòng)患者行環(huán)肺靜脈電隔離術(shù)前后應(yīng)用經(jīng)食道超聲心動(dòng)圖檢測左房結(jié)構(gòu)和各肺靜脈直徑的變化。方法：30例接受環(huán)肺靜脈電隔離術(shù)心房顫動(dòng)患者,分別于術(shù)前24-48小時(shí),術(shù)后24-48小時(shí)(近期),術(shù)后3個(gè)月(遠(yuǎn)期)應(yīng)用經(jīng)食道超聲心動(dòng)圖測量左上、左下、右上、右下四個(gè)肺靜脈直徑及右下肺靜脈血流速度,左房嵴寬變化,同時(shí)測量左房內(nèi)徑、左房長徑、左房橫徑。結(jié)果：1.左上、左下、右上肺靜脈直徑術(shù)后24-48小時(shí)較術(shù)前明顯減小(P0.05),術(shù)后3個(gè)月基本恢復(fù)到術(shù)前狀態(tài),左下肺靜脈直徑術(shù)后3月較術(shù)后24-48小時(shí)增大(P0.05)。右下肺靜脈術(shù)后24-48小時(shí)較術(shù)前有所減小,但無統(tǒng)計(jì)學(xué)意義(P0.05),右下肺靜脈血流速度術(shù)后24-48小時(shí)較術(shù)前明顯增快(P0.01),術(shù)后三個(gè)月較術(shù)后24-48小時(shí)有所減慢(P0.05),較術(shù)前有所增快,但無統(tǒng)計(jì)學(xué)意義(P0.05)；肺靜脈嵴部寬度術(shù)后24-48小時(shí)較術(shù)前明顯增寬(P0.01),術(shù)后3個(gè)月較術(shù)后24-48小時(shí)明顯減小(P0.01),基本恢復(fù)到術(shù)前狀態(tài),且比術(shù)前有減小趨勢,但無統(tǒng)計(jì)學(xué)意義(P0.05)。2.與術(shù)前相比,術(shù)后三月左房內(nèi)徑、橫徑、長徑均明顯縮小(P0.01),術(shù)后24-48小時(shí)左房內(nèi)徑、橫徑及長徑則無明顯變化。結(jié)論：1.環(huán)肺靜脈電隔離術(shù)近期內(nèi)會(huì)引起左房肺靜脈嵴變寬,遠(yuǎn)期逐漸變窄并較術(shù)前有所改善,同時(shí)造成左上、右上、左下肺靜脈近期內(nèi)變窄,遠(yuǎn)期內(nèi)逐漸恢復(fù),與術(shù)前無明顯變化。2.左房內(nèi)徑、橫徑、長徑術(shù)后三個(gè)月較術(shù)前及術(shù)后24-48小時(shí)逐漸縮小,術(shù)后24-48小時(shí)較術(shù)前則無明顯變化。
[Abstract]:Objective: to investigate the changes of left atrial structure and pulmonary vein diameter in patients with atrial fibrillation by transesophageal echocardiography before and after cyclic pulmonary vein isolation. Methods Twenty patients with atrial fibrillation underwent cyclic pulmonary vein isolation were measured by transesophageal echocardiography at 24 to 48 hours before operation, 24 to 48 hours after operation (short term, 3 months after operation). The diameter of the four right inferior pulmonary veins, the velocity of the right inferior pulmonary vein and the width of the left atrial crest were measured, and the diameter of the left atrium, the long diameter of the left atrium and the transverse diameter of the left atrium were measured at the same time. The result is 1: 1. The diameter of left upper, lower left and right superior pulmonary vein decreased significantly 24-48 hours after operation than that before operation, and the diameter of left inferior pulmonary vein returned to the preoperative state 3 months after operation, and the diameter of left inferior pulmonary vein increased in 3 months after operation than that in 24-48 hours after operation. The right inferior pulmonary vein decreased 24-48 hours after operation, but there was no significant difference (P 0.05). The blood flow velocity of right inferior pulmonary vein was significantly faster at 24-48 hours after operation than that before operation (P 0.01), and slowed down at 3 months after operation than that at 24 to 48 hours after operation, which was faster than that before operation. However, there was no significant difference in the width of pulmonary vein ridge between 24-48 hours after operation and that before operation (P 0.01a), 3 months after operation significantly decreased P0.01a, and basically returned to the preoperative state, and there was a decreasing trend as compared with that before operation, but there was no significant difference in the width of pulmonary vein between 24 and 48 hours after operation (P0.05U. 2). Compared with pre-operation, left atrial diameter, transverse diameter and long diameter decreased significantly in 3 months after operation, while left atrial diameter, transverse diameter and long diameter did not change at 24-48 hours after operation. Conclusion 1. In the near term, the left atrial pulmonary vein crest will become wider, narrow and improve in the long term. At the same time, the left upper, upper right and lower left pulmonary veins will become narrower in the short term, and gradually recover in the long term, and there is no significant change in the long term. 2. The internal diameter, transverse diameter and long diameter of left atrium gradually decreased in 3 months after operation compared with those before operation and 24 to 48 hours after operation, but there was no significant change between 24 and 48 hours after operation.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R541.75

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