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目的探讨尖端扭转性室速诊疗体会。方法回顾总结2007年1月至2010年10月收治的尖端扭转性室速38例临床资料。结果本组38例尖端扭转性室速患者经积极控制原发疾病及消除诱因治疗和应用硫酸镁、异丙肾上腺素、异搏定治疗35例Tdp得到控制,3例死于室速、室颤。结论尖端扭转性室速是临床急危情况,积极控制原发疾病和消除诱因;静脉应用硫酸镁是主要措施,积极采取静脉补钾,心率缓慢患者可应用异丙肾上腺素治疗,对无明显器质性心脏疾病可应用异搏定;救治需要临床根据患者情况进行积极调控。
Objective To explore the diagnosis and treatment of torsades de pointes. Methods The clinical data of 38 patients with torsades de pointes admitted from January 2007 to October 2010 were retrospectively reviewed. Results Totally 35 cases of Tdp were controlled by active control of primary disease and elimination of inducement and application of magnesium sulfate, isoprenaline and verapamil in 38 patients with trichothemic ventricular tachycardia. Three patients died of ventricular tachycardia and ventricular fibrillation . Conclusions Torsades de Pointes is a clinical critical situation, and actively control the primary disease and eliminate the incentive; intravenous application of magnesium sulfate is the main measure to actively take intravenous potassium, isoproterenol can be used in patients with slow heart rate, Verapamil can be used to treat cardiac diseases with quality heart disease; treatment needs to be actively controlled according to the patient’s condition.