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目的比较苯唑啉与丙吡胺治疗心血管术后阵发性心房纤颤的临床疗效。方法选取2014年10月—2016年3月乐亭县妇幼保健院收治的心血管术后阵发性心房纤颤患者96例。按照入院时间不同分为参照组和研究组,各48例。参照组患者给予丙吡胺治疗,研究组患者给予苯唑啉治疗,采用彩色多普勒超声对两组患者术前、术后E峰/A峰(E/A)、左室后壁厚度(LVPW)、室间隔厚度(IVS)、左室射血分数(LVEF)、左房直径(LAD)、左室舒张末期直径(LVDd)等相关指标进行测定和统计比较,并比较两组患者临床疗效,观察两组患者不良反应发生情况。结果两组患者术前、术后E/A、LVPW、IVS、LVEF、LAD、LVDd比较,差异无统计学意义(P>0.05)。研究组患者心脏复律成功率高于参照组,差异有统计学意义(P<0.05)。研究组行冠状动脉旁路移植术患者中终止心房纤颤发生率高于参照组,差异有统计学意义(P<0.05)。研究组患者接受其他心脏手术的患者中终止心房纤颤发生率高于参照组,差异有统计学意义(P<0.05)。治疗期间仅参照组出现不良反应2例,患者接受治疗后心房纤颤终止,无一例发生抗心律失常药物不良反应。结论苯唑啉治疗心血管术后阵发性心房纤颤的效果优于丙吡胺,适用于左心房较小和术前口服β受体阻滞剂的患者,且不良反应少。
Objective To compare the clinical efficacy of oxazoline and disopyramide in the treatment of paroxysmal atrial fibrillation after cardiovascular surgery. Methods A total of 96 patients with paroxysmal atrial fibrillation after cardiovascular surgery admitted to Laoting Maternal and Child Health Hospital from October 2014 to March 2016 were selected. In accordance with the different admission time is divided into reference group and study group, each 48 cases. Patients in the reference group were treated with pyridine, and patients in the study group were treated with oxazoline. Color Doppler echocardiography was used to evaluate the preoperative and postoperative E peak / A peak (E / A), left ventricular posterior wall thickness ( LVPW, IVS, LVEF, LAD, LVDd and other related indicators were measured and compared, and the clinical efficacy was compared between the two groups , Observed two groups of patients with adverse reactions occurred. Results There was no significant difference in preoperative and postoperative E / A, LVPW, IVS, LVEF, LAD and LVDd between the two groups (P> 0.05). The successful rate of cardioversion in study group was higher than that in reference group, the difference was statistically significant (P <0.05). The incidence of atrial fibrillation termination in study group patients with coronary artery bypass grafting was significantly higher than that in the reference group (P <0.05). The incidence of atrial fibrillation termination in study group patients receiving other cardiac surgery was higher than that in the reference group, with a significant difference (P <0.05). In the treatment group, only two cases of adverse reactions occurred in the reference group. After the treatment, the patient terminated the atrial fibrillation and none of them had adverse reactions of antiarrhythmic drugs. Conclusions Oxazoline is superior to disopyramide in the treatment of paroxysmal atrial fibrillation after cardiovascular surgery. It is suitable for patients with small left atrium and preoperative oral β-blocker, with less adverse reactions.