210例急性钡中毒心律失常分析

Cardiac arrhythmias occurring in 210 patients with acute barium poisoning

目的 探讨急性钡中毒时心律失常发生的意义。 方法 分析 2 1 0例急性钡中毒患者的心电图 ,其中男性 1 68例 ,女性 4 2例 ,年龄 1 1个月～ 84岁。 结果 2 5例发生室上性心律失常 ,1 0 2例发生多源性和 /或频发性室性早搏 ,2 0例发生心室扑动 /心室颤动 ,8例发生心室静止 ,3 8例发生房室阻滞和室内阻滞 ,由于低钾血症造成的心室复极异常有 1 3 9例。严重心律失常和呼吸肌麻痹是引起患者死亡的两个主要原因。 结论 急性钡中毒引起的心律失常是由于继发性低血钾、钡剂直接刺激心肌和中毒性心肌炎所致。

Objective To assess the cardiac arrhythmias occurring in acute barium poisoning. Methods The EGGs of 210 patients(168 males,42 females,ages ranging 11/12～84 yrs) suffering from acute barium poisoning were analysed. Results Supraventricular tachyarrhythmias occurred in 25 patients,frequent ventricular premature beats in 102 patients,ventricular flutter/fibrillation in 20 patients,ventricular standstill in 8 patients,atrio ventricular block and intraventricular block in 38 patients.Ventricular repolarization abnormalities due to hypokalemia occurred in 139 patients.Severe cardiac arrhythmias and respiratory muscle paralysis were the main causes of death in this series. Conclusion The arrhythmias in acute barium poisoning are due to secondary hypokalemia,direct effect of barium on myocardium,and toxic myocaritis.