硫酸镁预防肺叶切除术后房颤的前瞻性队列研究

Prevention of atrial fibrillation after lobectomy by infusion of magnesium sulfate: a prospective cohort study

目的评价围手术期预防性静脉应用硫酸镁对肺叶切除术后房颤（POAF）的有效性。方法采用术前年龄和POAF危险因素配对的方法,将103例手术患者根据是否应用硫酸镁分为硫酸镁组（n=49）和对照组（n=54）,硫酸镁组从术前3 d~术后3 d连续静脉应用25%硫酸镁2.5 g/d。观察的首要结局为POAF发生率,次要结局为有无不良反应以及其他并发症发生情况。结果 2组患者的临床资料比较差异无统计学意义,均衡性尚可;硫酸镁组POAF发生率低于对照组（6.1%vs 22.2%,P=0.026）;室上性心动过速和室性早搏也低于对照组,但差异无统计学意义。2组患者其他并发症发生率差异无统计学意义。结论围手术期静脉应用硫酸镁可降低POAF的发生率。进一步验证和临床推广尚需要大规模的随机对照研究。

Objective To evaluate the effectiveness of protective intravenous infusion of magnesiumsulfate in perioperation on postoperative atrial fibrillation（ PO AF） after the lobectomy.Methods The method of matching the preoperative age and risk factors of PO AF was adopted and 103 patients who underwent a scheduled lobectomy were divided into the magnesiumsulfate group（ n = 49） and control group（ n = 54）according to whether magnesiumsulfate was infused.Patients of the magnesiumsulfate group were infused with25% magnesiumsulfate of 2.5 g/d for 3 d before and after surgery.The primary end point to be observed was the incidence of PO AF and the secondary end point to be observed was the incidence of side effects and other complications.Results The differences of clinical data of two groups were not statistically significant.The incidence of PO AF of the magnesiumsulfate group was lower than that of the control group（ 6.1% vs 22.2%,P = 0.026）.The incidences of supraventricular tachycardia and ventricular premature beat of the magnesiumsulfate group were also lower than those of the control group, but the differences were not statistically significant.The differences of other complications of two groups were not statistically significant.Conclusion Intravenous infusion of magnesiumsulfate in perioperation can reduce the incidence of PO AF.M ore randomized controlled studies are needed for further verification and clinical application.