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通过对阵发性室上性心动过速患者随机应用不同剂量的三磷酸腺苷(ATP)或心律平进行对照研究,探讨 ATP在急诊中的应用价值。方法:2000～2002年急诊的无器质性心脏病的阵发性室上性心动过速50例,随机分成3组给予治疗,其中ATP0.1 mg/kg 组(A_1组)18例,ATP 0.2 mg/kg 组(A_2组)17例,心律平70mg 组15例。ATP 采用个体化给药,根据体重计算出相应剂量,不经稀释直接静脉推注,时间小于3s,后立即给予20ml 生理盐水快速同通道注射。心律平组采用70 mg 加入20 ml 生理盐水以10 ml/min 静脉注射,复律后立即停止注射。结果:应用上述药物均可有效终止发作,各组有效率之间无统计学差异(P>0.05),但 ATP 各组复律时间明显短于心律平组(P<0.001)。两组注射 ATP 后个别患者有胸闷、心悸等,均在4～7s 内自然缓解,无1例发生严重合并症者。结论:ATP 有效率高,复律快,短期内可重复使用等优点,改进给药方法后,用药剂量可减小,副作用减轻,可作为急诊终止室上性心动过速发作的一个有效方法。
Through the randomized patients with paroxysmal supraventricular tachycardia with different doses of adenosine triphosphate (ATP) or ventricular arrhythmia control study to explore the value of ATP in emergency. Methods: Fifty patients with paroxysmal supraventricular tachycardia without organic heart disease who were admitted to our hospital from 2000 to 2002 were randomly divided into three groups: 18 cases in ATP0.1 mg / kg group (A_1 group), ATP 17 in the 0.2 mg / kg group (A_2 group) and 15 in the 70 mg of ropivacaine group. ATP using individualized administration, calculate the corresponding dose according to body weight, direct intravenous injection without dilution, the time is less than 3s, immediately give 20ml normal saline fast same channel injection. Heart beat flat group with 70 mg added 20 ml of normal saline to 10 ml / min intravenous injection, immediately after cardioversion to stop injection. Results: All of the above drugs were effective in terminating the attack. There was no significant difference between the effective rates of each group (P> 0.05). However, the duration of cardioversion in ATP groups was significantly shorter than that of the cardiac rhythm group (P <0.001). Two groups of individual patients after injection of ATP chest tightness, palpitations, etc., were in 4 ~ 7s natural remission, no one case of serious complications. Conclusion: ATP has the advantages of high efficiency, rapid cardioversion and short-term reusability. After the administration method is improved, the dosage can be reduced and the side effects reduced, which can be used as an effective method to stop the onset of supraventricular tachycardia in emergency.