胺碘酮治疗心律失常75例临床分析

CLINICAL ANALYSIS OF TREATMENT OF ARRHYSTHMIA BY AMIODARONE——REPORT OF 75 CASES

目的:探讨胺碘酮抗心律失常作用的合理应用。方法:回顾分析应用胺碘酮治疗心律失常75例住院患者,男性51例,女性24例,平均年龄58.8岁,阿斯综合征发作3例,频发室早、室性心动过速45例、阵发性房颤房朴22例,频发房早、房速5例,观察心律失常控制情况、并发症及预后。结果:阿斯综合征3例中2例抢救成功,室性心律失常45例中43例发作均减少75%以上,房颤、房朴22例均恢复窦性心律,肝功能损害1例,突发室性逸搏心律2例,l例猝死,静脉炎17例,低血压反应6例。结论:胺碘酮对室早、室速、房早、房速及房颤均有明显控制作用,静脉胺碘酮主要用于急性心肌梗死、急性心力衰竭伴发的心律失常的治疗。对完全性左束支阻滞患者应用胺碘酮应检查窦房结及房室传导功能,加强病因的治疗。深静脉置管可以减少静脉炎的发生。

Objective：To study the reasonable application of amiodarone in arrhythmia. Methods： 75 cases were analyzed retrospectively;male 51,female 24;average age 58.8, 3 had Aase＇s syndrome, 45 had frequent ventricular ectopic beats and ventricular tachycardia, 22 had paroxysmal atrial fibrillation and atrial flutter, and 5 had frequent atrial ectopie beats and atrial tachycardia. Patients were treated with amiodarone,then the frequency of arrhythmia,complication,and prognosis were observed. Results：Two patients with Aase＇s syndrome were salvaged. The frequency of 43 ventricular arrhythmia decreased 75%.Patient with paroxysmal atrial fibrillation and atrial flutter all recovered normal sinus rhythm. The adverse effect of amiodarone was tiny：hepaticdys function 1 case,ventricular escape rhythm 2 cases,sudden death 1 case, phlebitis 17 cases, and hypotension 6 cases. Conclusion：Amiodarone has favourable curative effect on ventricular ectopic beats,ventricular tachycardia,atrial ectopic beats,atrial tachycardia and atrial fibrillation. Intravenous amiodarone was mainly applied to acute myocardial infarction and acute heart failure with arrhythmia. When amiodarone was used to patients with completed left bundle branch block, sinuatrial node and its conductive function must be inspected. Deep vein catheterization can decrease the occurrence of phlebitis.