摘要
目的:观察大剂量静脉应用胺碘酮治疗急性心肌梗死(AMI)并持续性室性心动过速(sustained ventricular tachycardia,SVT)的临床疗效及安全性.方法:对17例AMI并SVT患者首剂静脉注射胺碘酮150 mg,10 min内注入,随后以0.5～1.5 mg/min维持静脉滴注.若SVT控制不满意,间隔30 min追加75～150 mg负荷量,最多静脉注射达3次,同时口服胺碘酮.静脉用药2～9(4.53±1.8)d.结果:SVT控制率2 h内为47.1%(8/17),24 h内为64.7%(11/17),48 h内为82.4%(14/17),72 h内为88.2%(15/17).第一个24 h静脉用量为1 020～3 030(1 566±485)mg.治疗期间,2例(11.8%)出现窦性心动过缓,减量后心率恢复.3例(17.6%)血压降低,经用多巴胺后,血压上升正常.结论:大剂量静脉注射胺碘酮对AMI并SVT疗效明显,未见严重不良反应.用药过程中应严密监测心率、节律及血压变化.用药需强调个体化.
Objective: The efficacy and safety of large-dose intravenous amiodarone therapy for sustained ventricular tachycardia (SVT) in patients with acute myocardial infarction (AMI) were observed. Method:First dose of 150 mg of amiodarone was given via intravenous injection within 10 minutes,followed by 0.5~ 1.5 mg/min infusion. If SVT was not controlled, additional loading dose of 75~150 mg was repeated intravenously every 30 minutes, but no more than 3 times in total. Intravenous amiodarone infusion was maintained 2~9 ( 4.53± 1.8) days and oral amiodarone was started simultaneously.Result:The effective rate was 47.1%(8/17cases) within first 2 hours of treatment, 64.7%(11/17cases) within first 24 hours, 82.4%(14/17cases) within first 48 hours of treatment and 88.2%(15/17 cases)of the patients within first 72 hours of treatment. The total dose within the first 24 hours was 1 020~ 3 030( 1 566±485)mg. Sinus bradycardia was found in 11.8% (2/17 cases)of patients and the heart rate recovered to normal after the dose was reduced. Hypotension ocured in 17.6% (3/17 cases) of patients and the blood pressure increased to normal after dopamine was given.Conclusion: Large-dose intravenous amiodarone therapy for sustained ventricular tachycardia (SVT) in patients with acute myocardial infarction (AMI) is highly effective and quite safe. Heart rate, heart rhythm and blood pressure should be monitored during the treatment.
出处
《内科急危重症杂志》
2005年第1期29-31,共3页
Journal of Critical Care In Internal Medicine
