静脉注射艾司洛尔治疗交感风暴的临床观察

Clinical Observation of Esmolol in the Treatment of Sympathetic Storm with Intravenous Administration

目的:观察静脉注射艾司洛尔治疗交感风暴的临床疗效及安全性。方法:将48例交感风暴患者随机分为两组,对照组20例采用静脉注射胺碘酮及电复律等常规治疗;干预组28例在对照组治疗的基础上于1 min内静脉推注艾司洛尔0.5 mg/kg,然后给予0.05～0.2 mg(/kg·min)持续静脉滴注,视病情减量或停药。观察两组患者终止室性心动过速/心室颤动的成功率和电复律次数,以及出现心衰或原有心衰恶化、心动过缓、血压下降等的情况。结果:干预组患者平均电复律次数显著少于对照组患者,且终止室性心动过速/心室颤动的成功率(92.86%)显著高于对照组患者(35.00%),两组比较差异均有统计学意义(P<0.05)。两组患者心衰或原有心衰恶化、心动过缓、血压下降等的发生率比较差异无统计学意义(P>0.05)。结论:静脉注射艾司洛尔治疗交感风暴的疗效及安全性较好。

OBJECTIVE： To observe the clinical efficacy and safety of esmolol in the treatment of sympathetic storm with intra- venous administration. METHODS： 48 patients with sympathetic storm admitted were divided into 2 groups. 20 patients in control group were given conventional intravenous administration of amiodarone and treatment of electrical cardioversion; on the basis of control group, 28 patients in intervention group were given esmolol 0.5 mg/kg （intravenous injection within 1 min） and continuous intravenous infusion at 0.05-0.2 mg/（kg, min） which was reduced or discontinued depending on the disease condition. The success rate of terminating ventricular tachycardia or fibrillation, the number of electrical cardioversion as well as heart failure, primary de- terioration of heart failure, bradycardia arrhythmias, hypopiesia were all observed in 2 groups. RESULTS： The number of electrical cardioversion in intervention group was less than control group, and the effective rate of terminating ventricular tachycardia or fibril- lation in intervention group was 92.86%, which was significantly higher than 35.00% in control group; there was statistical signifi- cance （P〈0.05）. There were no significant differences in the difference of heart failure, primary deterioration of heart failure, hy- popiesia and bradycardia between 2 groups （P〉0.05）. CONCLUSIONS： Intravenous injection of esmolol is beneficial and safe.