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胺碘酮联合直流电复律在室性心动过速患者中的应用研究
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R541.7+1

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佛山市卫生和计划生育局医学科研课题项目(编号:20190356)


Application of Amiodarone and direct current cardioversion in patients with ventricular tachycardia
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    摘要:

    目的 研究应用胺碘酮联合直流电复律对室性心动过速患者窦性心律维持效果与左心功能的影响。方法 回顾性分析南方医科大学顺德医院(佛山市顺德区第一人民医院)2019 年 1 月至 8 月收治的 60 例室性心动过速患者的临床资料,依据治疗方法分为普罗帕酮组和胺碘酮组,各 30 例,两组患者分别在直流电复律前应用普罗帕酮和胺碘酮,两组患者治疗后均随访 3 个月。对比两组患者急性期电复律成功率、3 个月内室性心动过速复发率、复律时间,治疗前、治疗后 3 个月窦性心律维持效果,治疗前后左心功能及治疗后不良反应发生情况。结果 胺碘酮组患者复律时间显著短于普罗帕酮组(P < 0.05),而两组患者急性期电复律成功率、3 个月内室性心动过速复发率相比,差异均无统计学意义(均P > 0.05);与治疗前比,治疗后 3 个月两组患者最大 P 波时限、P 波离散度均显著缩短,且胺碘酮组均显著短于普罗帕酮组;与治疗前比,治疗后两组患者左心室射血分数均显著升高,且胺碘酮组显著高于普罗帕酮组,两组患者左心室内径均显著缩小,且胺碘酮组显著小于普罗帕酮组;治疗后胺碘酮组患者不良反应总发生率显著低于普罗帕酮组(均P < 0.05)。结论 相比于使用普罗帕酮,使用胺碘酮联合直流电复律能够显著缩短室性心动过速患者复律时间、最大 P 波时限及 P 波离散度,提高窦性心律维持效果和左心功能,且安全性较高。

    Abstract:

    Objective To study the effects of applying Amiodarone and direct current cardioversion in patients with ventricular tachycardia on the maintenance of sinus rhythm and left ventricular function. Methods A retrospective analysis of the clinical data of 60 patients with ventricular tachycardia admitted to the Shunde Hospital of Southern Medical University(The First People's Hospital of Shunde) from January to August 2019, according to the treatment method, they were divided into the Propafenone group and the Amiodarone group, 30 cases in each group. Patients of the two groups were treated with Propafenone group and Amiodarone group before direct currentcardioversion. Patients in both groups were followed up for 3 months after treatment. The success rate of acute electrical cardioversion, the recurrence rate of ventricular tachycardia within 3 months, the time of cardioversion, the maintenance effect of sinus rhythm before and 3 months after treatment, the left ventricular function before and after treatment, and the occurrence of adverse reactions after treatment were compared between the two groups of patients. Results The cardioversion time of patients in the Amiodarone group was significantly shorter than that in the Propafenone group (P < 0.05), and there was no significant difference between the two groups of patients in the success rate of acute electrical cardioversion and the recurrence rate of ventricular tachycardia within 3 months (all P >0.05); compared with before treatment, the maximum P wave time limit and P wave dispersion of the two groups of patients significantly shortened 3 months after treatment, and the Amiodarone group was significantly shorter than that of the Propafenone group; compared with before treatment, the left ventricular ejection fraction of the two groups of patients significantly increased after treatment, and the Amiodarone group was significantly higher than that of the Propafenone group, and the left ventricular diameter of the two groups significantly reduced after treatment, and the Amiodarone group was significantly smaller than that of the Propafenone group; after treatment, the total incidence of adverse reactions in the Amiodarone group was significantly lower than that in the Propafenone group (all P < 0.05). Conclusion Compared with the use of Propafenone, the use of Amiodarone and direct current cardioversion can significantly shorten the cardioversion time, maximum P wave time limit and P wave dispersion in patients with ventricular tachycardia, improve sinus rhythm maintenance and left ventricular function, and has higher safety

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  • 在线发布日期: 2022-09-15
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