院前急救无创临时起搏对缓慢性心律失常或心脏停搏的治疗探讨

目的研究院前急救中无创临时起搏技术在治疗缓慢性心律失常或心脏停搏患者时的疗效，为提高该病症的急救成功率提供参考。方法选取2010年1月～2014年1月肇庆市第二人民医院院前急救的缓慢型心律失常（Ⅱ度Ⅱ型房室传导阻滞以上）和心脏停搏的患者103例，分组进行无创起搏及药物治疗后观察。结果起搏组中A1组24例心跳停搏患者中13例起搏成功，起搏成功率为541％。平均起搏阈值为（8125±1758）mA。起搏组中B1组29例缓慢心律失常患者中28例心脏起搏成功，平均起搏阈值为（68．45±1087）mA，成功率为96．5％，所有进行无创临时起搏治疗的患者均未出现其他并发症。药物组中A2组24例心跳停搏患者中有5例抢救成功，成功率为20．8％；B2组26例缓慢心律失常患者中有17例患者经静点异丙肾上腺素心率提升，血压上升可以减轻头昏，昏厥症状，治疗有效率65j％，起搏组和药物治疗组抢救成功率统计学比较，差异有统计学意义（P〈0．05）。结论对缓慢性心律失常或心脏停搏患者进行院前急救时应用无创临时起搏，治疗效果好。特别适合于狭小抢救空间，缺乏众多医护人员的院前急救应用，为院前急救心脏急症患者开辟新的抢救途径。因此临床实践中应加以推广应用。

Objective Research in pre-hospital noninvasive temporary pacing in the treatment of slow arrhythmia or cardiac arrest patients, curative effect, to provide reference for improving the success rate of emergency conditions. Methods The first aid center selected 103 cases of cardiac arrest transport and heartbeat bradycardia, observation of noninvasive pacing group and drug treatment. Results Pacing group A 1 group of 24 patients with cardiac arrest in 13 cases, successful pacing, the success rate of pacing for 54.1%. The average pacing threshold is （81.25~17.58） mA.Pacing group B 1 group of 29 patients with slow arrhythmia in patients with 28 cases of cardiac pacing success, the average pacing threshold is （68.45~10.87）mA, the success rate is 96.5%, other complications were not seen in all the noninvasive temporary pacing therapy. The drug group A 2 group of 24 patients with cardiac arrest patients were 5 cases of successful rescue. The successful rate was 20.8 %. B 2 group of 26 patients with slow arrhythmia in 17 patients were treated by intravenous isoproterenol heart rate and a rise in blood pressure which can reduce the symptoms of dizziness, fainting, the effective rate of treatment 65.3%. Pacing group and drug treatment group, the success rate of rescue statistics （P〈0.05）, significant difference. Conclusion The noninvasive temporary pacing which is used slow arrhythmia or cardiac arrest patients are pre hospital emergency treatment,which has a good effect. Particularly suiting for small rescue space, the lack of many medical personnel prehospital emergency application. Open up new ways to rescue cardiac emergency patients in pre hospital emergency. So it should be popularized and applied in clinical practice.