胺碘酮在急性心肌梗死院前急救中预防性应用的研究

Study on Prophylactic Application of Amiodarone in Treatment of Acute Myocardial Infarction in Pre-hospital Care

目的:探讨在急性心肌梗死(AMI)院前急救中预防性应用胺碘酮对恶性心律失常的发生、除颤使用率的影响及安全性。方法:采用前瞻性随机对照原则,将院前急救过程中诊断ST段抬高型AMI的患者94例,分为预防性应用胺碘酮实施组和常规治疗组,统计恶性心律失常、除颤、死亡、不良反应例数。结果:实施组43例,对照组51例。恶性心律失常发生率分别为21%和90%(P<0.01);除颤使用率分别为9.3%和23.5%(P<0.01);死亡率分别为2.3%和5.9%(P<0.05);实施组不良反应9例。结论:在AMI院前急救中,预防性应用胺碘酮可显著降低恶性心律失常发生率,减少除颤的使用率,增加抢救成功率,无严重不良反应。

Objective： To explore the effect of prophylactic application of amiodarone on malignant arrhythmia in pre-hospital care for treatment of acute myocardial infarction （AMI） and its safety. Methods： Ninety-four patients diagnosed as ST elevated AMI in pre-hospital care were divided into two groups： Amiodarone prophylactic appIication group and routine treatment group. Cases of malignant arrhythmia, reversion of fibrillation, death and adverse reaction were statistically analyzed. Results： The rate of malignant arrhythmia were 21% in amiodarone prophylactic application group and 90% in routine treatment group （P〈0. 01）. The rate of reversion of fibrillation were 9. 3% in amiodarone prophylactic application group and 23. 5% in routine treatment group （P〈0. 01）. The death rate were 2. 3% in amiodarone prophylactic application group and 5, 9% in routine treatment group （P〈0. 05）. Adverse reactions were observed in 9 cases in amiodarone prophylactic application group. Conclusions： Prophylactic application of amiodarone can signifieantly decrease the incidence of malignant arrhythmia, decrease the utilization rate of defibrillator, increase the rate of successful rescue, and with no severe adverse reaction.