心室纤颤频率及振幅对电除颤的影响

Influence of frequency and amplitude of ventricular fibrillation on defibrillation

目的探讨心室纤颤（室颤）患者行紧急电除颤（defibrillation，DF）治疗时室颤频率及振幅对DF成功率的影响。方法66例室颤患者依据DF前5S的室颤波形，分为频率≤200、〉200～400、〉400～500、〉500次／min组和振幅≤0．2、〉0.2～0．6、〉0.6～1．0、〉1．0mV组，观察不同室颤波频率及振幅的DF治疗效果，分析室颤波频率与振幅的相关性。结果（1）室颤频率〉400～500、〉500次／min以及振幅〉0．6～1．0、〉1．0mV时，DF治疗成功率分别为91．3％、95．0％和92．3％、100．0％，高于室颤频率≤200、〉200～400次／min（11．1％、28．6％）及振幅≤0．2、〉0．2～0．6mV（8．3％、33．3％）时DF治疗成功率，差异均有统计学意义（P〈0.01或P〈0.05）；（2）线性相关性统计分析显示，室颤波的频率与振幅呈正相关性（r=0．401，P=0．001）。结论随室颤频率和／或振幅增加，DF治疗成功率提高，室颤波的频率及振幅可有效预测DF治疗成功率。

Objective To discuss the influence of frequency and amplitude of ventricular fibrillation （VF） on the defibrillation success rate in patients needing emergent defibrillation. Methods Sixty-six patients were divided into 200, 〉200 ～400, 〉400 ～500 and 〉500 beat/min frequency groups, and ≤0.2, 〉0. 2 ～0.6, 〉0.6～1.0 and 〉 1.0 mV amplitude groups according to VF waveform 5 seconds before defibrillation, to observe the influence of frequency and amplitude of VF on the defibrillation outcome and analyze the relationship between frequency and amplitude. Results The DF success rates were 91.3%and 95.0% in 〉400～500 and 〉500 beat/rain groups, and were 92.3% and 100.0% in 〉0.6～1.0 and 〉1.0 mV groups, significantly higher than those in 4200 and 〉200～400 beat/min groups （11.1 %, 28.6%） and in ≤0. 2 and in 〉0. 2～0. 6 mV groups （8. 3%, 33. 3%） （P〈0. 01 or P〈0. 05）. Linear correlation analysis showed frequency was positively correlated with amplitude of VF waveform （r= 0. 401, P= 0. 001 ）. Conclusion With the increase of frequency and/or amplitude of VF waveform, DF success rate increases. The frequency and amplitude may predict the DF success rate.