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本文引用的文献

1
Video-assisted thoracoscopic surgery versus open lobectomy for primary non-small-cell lung cancer: a propensity-matched analysis of outcome from the European Society of Thoracic Surgeon database.电视辅助胸腔镜手术与开放性肺叶切除术治疗原发性非小细胞肺癌：基于欧洲胸外科医师协会数据库结果的倾向匹配分析
Eur J Cardiothorac Surg. 2016 Feb;49(2):602-9. doi: 10.1093/ejcts/ezv154. Epub 2015 Apr 26.
2
Role of the autonomic nervous system in atrial fibrillation: pathophysiology and therapy.自主神经系统在心房颤动中的作用：病理生理学与治疗。
Circ Res. 2014 Apr 25;114(9):1500-15. doi: 10.1161/CIRCRESAHA.114.303772.
3
Incidence, severity and perioperative risk factors for atrial fibrillation following pulmonary resection.肺切除术后房颤的发生率、严重程度及围手术期危险因素
Interact Cardiovasc Thorac Surg. 2014 Mar;18(3):340-6. doi: 10.1093/icvts/ivt520. Epub 2013 Dec 12.
4
Local innervation and atrial fibrillation.局部神经支配与心房颤动
Circulation. 2013 Oct 1;128(14):1566-75. doi: 10.1161/CIRCULATIONAHA.113.001596.
5
Does video-assisted thoracic surgery provide a safe alternative to conventional techniques in patients with limited pulmonary function who are otherwise suitable for lung resection?对于肺功能有限但其他方面适合肺切除术的患者，电视辅助胸腔镜手术能否提供一种比传统技术更安全的替代方案？
Interact Cardiovasc Thorac Surg. 2013 Jul;17(1):159-62. doi: 10.1093/icvts/ivt097. Epub 2013 Mar 26.
6
Autonomic nerves in pulmonary veins.肺静脉中的自主神经。
Heart Rhythm. 2007 Mar;4(3 Suppl):S57-60. doi: 10.1016/j.hrthm.2006.12.011. Epub 2006 Dec 15.
7
Video-assisted thoracic surgery does not reduce the incidence of postoperative atrial fibrillation after pulmonary lobectomy.电视辅助胸腔镜手术并不能降低肺叶切除术后房颤的发生率。
J Thorac Cardiovasc Surg. 2007 Mar;133(3):775-9. doi: 10.1016/j.jtcvs.2006.09.022.
8
Autonomic innervation and segmental muscular disconnections at the human pulmonary vein-atrial junction: implications for catheter ablation of atrial-pulmonary vein junction.人类肺静脉-心房交界处的自主神经支配和节段性肌肉分离：对肺静脉-心房交界处导管消融的影响
J Am Coll Cardiol. 2006 Jul 4;48(1):132-43. doi: 10.1016/j.jacc.2006.02.054. Epub 2006 Jun 12.
9
Video-assisted thoracic surgery lobectomy: experience with 1,100 cases.电视辅助胸腔镜肺叶切除术：1100例经验
Ann Thorac Surg. 2006 Feb;81(2):421-5; discussion 425-6. doi: 10.1016/j.athoracsur.2005.07.078.
10
Statin use is associated with a reduction in atrial fibrillation after noncardiac thoracic surgery independent of C-reactive protein.在非心脏胸外科手术后，他汀类药物的使用与房颤发生率降低相关，且与C反应蛋白无关。
Chest. 2005 Nov;128(5):3421-7. doi: 10.1378/chest.128.5.3421.

电视辅助肺叶切除术与开胸肺叶切除术后心房颤动及心率变异性改变

Atrial fibrillation and alteration of heart rate variability after video-assisted pulmonary lobectomy versus thoracotomy pulmonary lobectomy.

作者信息

He Gengxu, Yao Tong, Zhao Lei, Geng Hong, Ji Qiang, Zuo Kun, Luo Yuanzhi

机构信息

Department of Thoracic and Cardiovascular Surgery, The First Affiliated Hospital of Hebei North University, Zhangjiakou City, Hebei Province, P.R. China.

Department of Cardiac Function Examination, The First Affiliated Hospital of Hebei North University, Zhangjiakou City, Hebei Province, P.R. China.

出版信息

J Cardiothorac Surg. 2020 Aug 14;15(1):220. doi: 10.1186/s13019-020-01260-6.

DOI:10.1186/s13019-020-01260-6
PMID:32795332
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7427877/
Abstract

OBJECTIVE

To compare the incidence of atrial fibrillation (AF) and alteration of heart rate variability (HRV) after pulmonary lobectomy through video assisted thoracic surgery or thoracotomy, and to explore the role of autonomic nerves in the pathogenesis of atrial fibrillation after pulmonary lobectomy.

METHODS

In a single institution, 224 patients (age > 60) with normal sinus rhythm were enrolled in the study. Experienced surgeons and anesthetists carried out operation and anesthesia according to the same procedure. The hearts were monitored using Holter for more than 96 h. Any new-onset AF was recorded and HRV was analyzed at different time intervals.

RESULTS

One hundred twelve patients undergoing video-assisted thoracic surgery (VATS) and 112 patients undergoing thoracotomy (THOR) were matched for age and gender. Atrial fibrillation occurred in 39 patients, with a similar incidence between the two groups (VATS: 19/112, 16.9% and THOR: 20/112, 17.9%, P = 0.82). The post-operational heart variability at different time intervals was comparable between the two groups.

CONCLUSION

Pulmonary lobectomy through video assisted thoracic surgery does not reduce the postoperative atrial fibrillation. Autonomic nerve mechanism may be involved in the pathogenesis of postoperative atrial fibrillation.

摘要

目的

比较电视辅助胸腔镜手术或开胸肺叶切除术后房颤（AF）的发生率及心率变异性（HRV）的改变，探讨自主神经在肺叶切除术后房颤发病机制中的作用。

方法

在单一机构中，纳入224例年龄>60岁、窦性心律正常的患者进行研究。经验丰富的外科医生和麻醉师按照相同程序进行手术和麻醉。使用动态心电图监测心脏超过96小时。记录任何新发房颤情况，并在不同时间间隔分析HRV。

结果

112例行电视辅助胸腔镜手术（VATS）的患者和112例行开胸手术（THOR）的患者在年龄和性别上相匹配。39例患者发生房颤，两组发生率相似（VATS组：19/112，16.9%；THOR组：20/112，17.9%，P = 0.82）。两组在不同时间间隔的术后心脏变异性相当。

结论

电视辅助胸腔镜肺叶切除术不会降低术后房颤的发生率。自主神经机制可能参与了术后房颤的发病过程。