无症状患者术后突发室上性心动过速15例患者的治疗分析

Treatment Analysis on Sudden SVT after Operation to Non-symptom Patients

[目的]避免或减少无症状患者急诊手术后突发室上性心动过速等风险因素的存在与发生。[方法]对我院2007年11月至2011年11月无症状患者术后突发室上性心动过速的15例患者的治疗予以分析。治疗为常规手术麻醉,适当加深麻醉水平,监护心电图、血压、血氧饱和度,气管插管。当心室率加快立即嘱其深呼吸,分别实行按压右侧颈动脉窦,应用西地兰、普罗帕酮、胺碘酮。待所有患者心室率均下降至100次/min以下,心律转复为窦性后,继续面罩吸氧严密观察15min,而患者能保持心律平稳,抬头可坚持5s,呼吸平顺有力后护送至病房,和病区护士详细交班。[结果]所有患者心律失常均消失,心律规则,安返病房,无重大并发症发生。[结论]室上性心动过速容易继续进展为更严重的心律失常,必须早期进行治疗,使心室率下降至<120次/min,配合心律失常的药物,必要时请心内科医生会诊,甚至使用直流电转复术,以尽快使心律转复。

[Objective] To avoid or reduce the existence and occurrence of risk factors for sudden SVT after operation to non-symptom emergency patients. [Method] Select 15 cases for analysis. Take routine operational anesthesia, supervise ECG, blood pressure, oxyhemoglobin saturation and make trachea cannula; when ventricle rate speeds up, press right carotid sinus, apply cedilanid, propafenone and amiodarone. When it lowers to less than 100times/min, continue oxygen uptake for 15min. [Result] All arrhythraia disappears, without main complications. [Conclusion] SVT can develop into severe arrhythmia, it must be treated as early as possible; the ventricle rate less than 120times/min is safer; if necessary, invite cardiology doctors for diagnosis, even use current cardioversion to recover heart rate.