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目的通过对照研究不同用药方式对三磷酸腺苷(ATP)急诊治疗阵发性室上性心动过速(PSVT)疗效的影响,探讨ATP的有效给药方法。方法2000年3月~2004年11月急诊无器质性心脏病的阵发性心动过速患者52例,随机分成三组给予治疗,A1组18例,A2组17例,A3组17例。A1、A2组根据体重计算出ATP相应剂量,初剂0.1mg/kg,如未转复心律,再予以0.2mg/kg、0.3mg/kg。A3组初剂采用ATP10mg,以10mg为递增量用药。A1组及A3组ATP直接静脉推注后立即给予20ml生理盐水快速同通道注射,A2组ATP稀释5倍后在3秒内快速静脉注射,随即以10ml生理盐水快速冲洗。结果应用上述用药方法均可有效终止发作,个别患者有胸闷、心悸等症状,均在2分钟内自然缓解,无1例发生严重并发症者。3组中A2组转复时间延长,窦性停搏时间缩短,转复成功率降低(P<0.05);A3组患者ATP的使用剂量及副作用发生率增加(P<0.05)。结论ATP采用个体化用药,从小剂量开始,选择合适的给药方法可以减小其用药剂量,降低副作用,可作为急诊终止室上性心动过速发作的一个有效方法。
Objective To study the effect of different administration methods on the efficacy of adenosine triphosphate (ATP) in the treatment of paroxysmal supraventricular tachycardia (PSVT) and to explore the effective administration of ATP. Methods From March 2000 to November 2004, 52 patients with paroxysmal tachycardia without organic heart disease were randomly divided into three groups: 18 in group A1, 17 in group A2 and 17 in group A3. A1, A2 group calculated according to the weight of ATP corresponding dose, the first dose of 0.1mg / kg, if not transferred rhythm, and then to 0.2mg / kg, 0.3mg / kg. A3 group of the first dose of ATP10mg, in order to increase the amount of 10mg medication. Immediately after bolus injection of ATP in group A1 and A3, bolus injection of 20 ml normal saline was given immediately. ATP in group A2 was rapidly intravenously injected within 3 seconds after being diluted by 5-fold with ATP, and then rapidly rinsed with 10 ml of normal saline. Results The application of these methods can effectively terminate the attack, some patients have chest tightness, heart palpitations and other symptoms, were naturally relieved within 2 minutes, no one case of serious complications. In A2 group, the recovery time of A2 group was shortened, the time of sinus arrest was shortened and the successful rate of recovery was decreased (P <0.05). The dosage and side effects of ATP in A3 group were increased (P <0.05). CONCLUSIONS: ATP is administered individually. Starting from a small dose, choosing appropriate dosage method can reduce its dosage and reduce side effects. It can be used as an effective method to stop the onset of supraventricular tachycardia in emergency.