胺碘酮对心瓣膜置换术后阵发性心房颤动的疗效

Efficacy of intravenous and oral amiodarone in paroxysmal atrial fibrillation after heart valve replacement

目的观察胺碘酮对心脏瓣膜置换术后病人心房颤动的临床疗效。方法选择瓣膜置换术后心房颤动病人113例,其中胺碘酮组62例,非胺碘酮组51例,胺碘酮组给予胺碘酮0.15g静脉注射后,以600μg/min持续静脉泵入,同时开始给予口服胺碘酮0.2g,每日3次,7d后改为0.2g,每日2次,连用7d后再改为0.2g,每日1次维持。非胺碘酮组则给予强心苷或短效β-受体阻断药。比较术后10d及术后3个月临床资料。结果两组年龄、性别、术前心率、心脏复跳后窦性心律次数、心房颤动发作时心率、及术中阻断时间、体外循环时间、术后左心房大小差异无统计学意义。胺碘酮组术后10d和3个月心房颤动转复和窦律维持比率分别为32/62和42/62,高于非胺碘酮治疗组6/51和4/51(P=0.000)。结论静脉及口服胺碘酮治疗心脏瓣膜置换术后心房颤动,有提高转复率和减少术后复发率作用。

Objectives To observe the clinical efficacy of amiodarone for paroxysmal AF after operation of heart valve replacement. Methods One hundred and thirteen patients who had occurred paroxysmal AF after operation of heart valve replacement were studied retrospectively, sixty-two patients of AF after operation of heart valve replacement were treated with loaded intravenous amiodarone (150 mg), and then continue dripped 600 ?滋g/min,united with oral amiodarone; The other fifty-one patients were given digitalis orβ-blocker. Then compared their clinical digital with statistic analysis. Results The two groups had no significant correlation in age, grander, heart rate before and after operation, the time of bypass and diameter of left atrium after operation; The treatment group had significant efficacy in return and maintain sinus rhythm(P<0.001). Conclusions It is effective united with intravenous and oral amiodarone in treatment of paroxysmal AF after operation of heart valve replacement.