阵发性室上性心动过速院外再次给药的临床研究

Clinical research on second application of drug for supraventricular tachycardia ZHANG

目的：探讨阵发性室上性心动过速再次用药的临床疗效。方法回顾性分析2010年2月-2013年2月北京急救中心接诊的 PSVT 患者426例，分为普罗帕酮组，胺碘酮组，维拉帕米组，再次用药246例，比较首次用药的显效率，再次用药的总显效率，转复时间。再用药各组间的显效率，有效率，无效率。结果三组首次用药显效率普罗帕酮与维拉帕米，差异无统计学意义（P 〉0.05），普罗帕酮，维拉帕米与胺碘酮，差异有统计学意义（P 〈0.05）。三组再次用药使用首次用药在总有效率，差异无统计学意义（P 〉0.05）。三者在转复时间上普罗帕酮，维拉帕米与胺碘酮，差异有统计学意义（P 〈0.05）。三组再次用药普罗帕酮组：a与c无明显差异，a与b存在明显差异，b无效明显增高与a，c差异有统计学意义（P 〈0.05）。胺碘酮组：换用药物呈现首次用药特征，a与b，c有效率，差异有统计学意义（P 〈0.05）。维拉帕米组：a显效率高于其它两组，差异有统计学意义（P 〈0.05），采取用药后配合物理等方法也有一定效果。结论由此得出三种药物均为治疗的有效药物，普罗帕酮和维拉帕米在转复时间上优于胺碘酮。再用药时选择药物加量要胜于换用药物，差异无统计学意义（P 〈0.05）。维拉帕米与普罗帕酮和胺碘酮机制的不同使其在首次用药时要给于鉴别。

Objective To explore the effect of second application of drug on supraventricular tachycardia. Methods A retrospective analysis was conducted in between February 2010 and February 2013 on 426 patients with PSVT. They were divided into three groups, Propafenone group, Verapamil group, and Amineiodine group. Among them, 246 patients were given drug for a second time. Efficiency of drugs between the groups were evaluated and compared. Results It reflected no significant difference between propafenone group and verapamilarenot group for the first time of application （P 〉0.05）. It reflected a significant difference in propafenone on cardioversion, amiodarone and verapamil （P 〈0.05）. Three groups on propafenone： no significant difference was found in a and c, but a clear difference seen in a and b （P 〈0.05）. Amiodarone group： swap with a drug renders the medication for the first time featured a significant difference （P 〈0.05）. Verapamil groups： a is more efficient than the other two groups with a significant differences （P 〈0.05）, after taking medication combined with physical therapy.Conclusion It is considered that three drugs being effective. Verapamil may increase efficiency in participating in the group. Selecting drug in quantity is more than swapping drugs. Due to different mechanism of propafenone, amiodarone, and verapamil, it becomes imperative to identify them when given for the first time.