应用胺碘酮干预急诊冠心病快速型心律失常的临床疗效观察

The Observation of Clinical Effect of the Interventional Treatment with Amiodarone on Patients with Coronary Heart Disease with Tachyarrhythmia in Emergency

目的观察总结应用胺碘酮治疗冠心病合并快速型心律失常的临床效果。方法收集2012年2月—2013年9月在我院急诊科就诊的冠心病快速型心律失常患者113例,观察和总结胺碘酮的临床效果以及应用胺碘酮治疗各种类型快速心律失常的有效性。结果经过临床病例的观察和总结,113例冠心病快速型心律失常患者经胺碘酮治疗后,97例显效或有效,总有效率为85.8%;在各心律失常类型中,阵发性房颤的转复率最高,为95.5%,其次为室性早搏,为91.1%,明显高于阵发性室上性心动过速(PSTV)、室性心动过速及持续性房颤的转复率,差异具有统计学意义(χ2=10.4682,P<0.05)。结果显示无效9例,出现不良反应7例,其中有5例患者出现血压下降,降至90/60 mm Hg,2例心率降低至50次/min,经过对症治疗后症状均缓解。结论本研究提示,胺碘酮治疗心律失常类型中,对阵发性房颤的有效率最高,室性早搏其次,两者有效率明显高于对PSTV、室性心动过速及持续性房颤的转复率。临床上治疗冠心病快速心律失常急诊应用胺碘酮起效快,安全性高,值得临床推广使用。

OBJECTIVE To observe the clinical effect of the application of Amiodarone in 113 cases of coronary heart disease with tachyarrhythmia in emergency. METHODS Assemble the data of 113 cases of coronary heart disease with tachyarrhythmia from Febru- ary 2012 to September 2012 in our hospital emergency department, observe and summarize the clinical effect of the application of Amiodarone and the difference of therapeutic effect between different types of tachyarrbythmia. RESULTS Through clinical observa- tion and summary, after the treatment of the whole 113 cases with Amiodarone, the effect is excellent and effective in 97 cases, total effective rate was 85.8%. Greater effectiveness in cardioversion is observed in paroxysmal AF and ventricular premature beat, the ef- fective rate is 95.5% and 91.1% separately, much higher than that of PSTV, VT and persistent AF. The difference was statistically significant （X 2 =10.4682, P〈0.05）. CONCLUTION Application of amiodarone in treatment of coronary heart disease with rapid ar- rhythmia takes effect more quickly and has high security, so amiodarone was worth clinical promotion use.