心脏外科围术期心室电风暴救治分析

Cardiac surgery perioperative treatment with ventricular electrical storm

目的总结分析心脏直视手术后10例患者发生心室电风暴的病因及治疗方法。方法 10例患者24 h内发生室速/室颤2次以上,均给予电除颤、胸外心脏按压、胺碘胴/β受体阻滞剂等综合治疗。结果本组心脏手术围术期发生心室电风暴的死亡2例,1例择期置入ICD。结论心脏手术围术期应避免出现诱发心室电风暴的原因;心室电风暴在反复电复律时,应尽快使用胺碘酮,在无低心排表现时联合使用β受体阻滞剂,及时纠正各种诱因,维持电解质等内环境稳定,是治疗的重点。

Objective To summarize and analyze the etiology and treatments of heart surgery perioperative combined with ventricular e -lectrical storm.Methods A total of 10 patients with ≥2 attacks of ventricular tachycardia and fibrillation within 24 hours were treated with comprehensive therapies including electric defibrillation , external chest compression , and antiarrhythmic treatment with amiodarone/beta -blockers.Results During heart surgery perioperative combined with ventricular electrical storm 2 cases died, 1 cases selective operation im-plant ICD.Conclusion During heart surgery perioperative should avoid incentives; Ventricular electrical storm in cardioerter repeatedly , should use of amiodarone as soon as possible , No low cardiac output syndrome happened should performance combination of beta blockers , time-ly corrective all kinds of incentive , stable electrolyte and so on environment is the key of the treatment .