论文部分内容阅读
目的观察低能量胸外直流电除颤和静脉应用β-受体阻滞剂治疗室性心律失常风暴的临床疗效及其安全性。方法将室性心律失常风暴患者59例随机分为对照组和艾司洛尔组,其中,对照组31例患者给予静脉应用利多卡因或胺碘酮基础上采用常规电复律治疗;艾司洛尔组28例患者在上述药物治疗基础上静脉给予艾司洛尔并给予低能量电复律治疗。结果艾司洛尔组终止反复室速、室颤成功率显著高于对照组(89.71%vs 39.89%,P<0.05),终止室速及室颤所需放电次数[(5.69±1.34)次]和平均放电能量[(95.32±13.21)J]显著少于对照组[(8.63±3.79)次,(P<0.05)]和[(185.39±25.63)J,(P<0.05)];两组低血压和缓慢性心律失常的发生率比较差异无统计学意义(45.16%vs 39.29%,3.23%vs 3.57%,38.71%vs 39.29%,P>0.05);对照组电复律后总肌酸激酶和乳酸脱氢酶的升高值显著高于艾司洛尔组(P<0.01);艾司洛尔组中患者的病死率显著低于对照组(6例,21.43%vs 24例,77.42%,P<0.01)。结论在常规药物治疗基础上,及时、足量地静脉注射β-受体阻滞剂和低能量电复律治疗室性心律失常风暴是非常有效而且安全的。
Objective To observe the clinical efficacy and safety of low-energy DC defibrillation and intravenous β-blocker in the treatment of storm of ventricular arrhythmia. Methods Fifty-nine patients with storm of ventricular arrhythmia were randomly divided into control group and esmolol group, in which 31 patients in the control group were treated with intravenous lidocaine or amiodarone on the basis of conventional cardioversion; Twenty-eight patients in the lol group received esmolol intravenously on the basis of the above drug therapy and were given low-energy cardioversion. Results The rates of termination of ventricular tachycardia and ventricular fibrillation in esmolol group were significantly higher than those in control group (89.71% vs 39.89%, P <0.05), and the number of discharges required to terminate ventricular tachycardia and ventricular fibrillation were 5.69 ± 1.34 (95.32 ± 13.21) J were significantly lower than those in the control group (8.63 ± 3.79), (P <0.05), and (185.39 ± 25.63) J, respectively There was no significant difference in the incidence of blood pressure and bradyarrhythmia (45.16% vs 39.29%, 3.23% vs 3.57%, 38.71% vs 39.29%, P> 0.05) Lactate dehydrogenase increased significantly higher than esmolol group (P <0.01); Esmolol group patients mortality was significantly lower than the control group (6 cases, 21.43% vs 24 cases, 77.42% P <0.01). Conclusions Based on conventional drug therapy, it is very effective and safe to treat β-blockers and low-energy cardioversion ventricular arrhythmia storm timely and adequately.