胺碘酮对恶性室性心律失常治疗的疗效观察

Observation on therapeutic effect of amiodaron in the treatment of malignant ventricular arrhythmias

目的 :观察胺碘酮对恶性室性心律失常治疗的疗效。方法 :对收入 CCU符合入选条件的 6 7例恶性室性心律失常患者随机分为 2组治疗。治疗组 32例 :部分病例采用胺碘酮转复 ;其余采用电转复 ,成功后用胺碘酮维持窦性心律 (窦律 )。对照组 35例 :应用利多卡因转复及维持窦律 ;利多卡因无效者改用胺碘酮治疗。结果 :治疗组转复成功率 83.33% (10 /12 ) ,维持窦律成功率 81.2 5 % (13/16 ) ,总有效率 78.12 % (2 5 /32 ) ,均明显高于对照组〔分别为 5 7.14 % (8/14 )、6 2 .2 5 % (10 /16 )和 5 4 .2 9% (18/35 )〕,且对照组中应用利多卡因转复及维持窦律失败的部分病例使用胺碘酮仍有效。结论 :胺碘酮是治疗恶性室性心律失常最有效的药物之一 ,特别是应用其它抗心律失常药物治疗无效的病例 ,应用胺碘酮可收到良好的治疗效果。

Objective:To observe the efficacy of amiodarone in patients with malignant ventricular arrhythmias. Methods:Sixtyseven CCU patients who matched the diagnostic criteria of malignant ventricular arrhythmias were entered for study.The patients were divided into two groups.Thirtytwo patients were in the treatment group,and amiodarone was used in a part of the patients in the group for cardioversion,and synchronized direct current cardioversion was carried out in the other patients.Then,amiodarone was used for the maintenance of sinus rhythm after cardioversion.Thirtyfive patients were in control group,and lidocaine was used for cardioversion and for the maintenance of sinus rhythm after cardioversion.Some patients failed to respond to lidocaine,and these patients were treated with amiodarone.Results:In treatment group,the successful reversion rate was 83 33%(10/12),the maintenance rate was 81 25%(13/16) and the all effective rate was 78 12%(25/32).All the rates were higher than that of the control group.The rates of the control group were 57 14%(8/14),62 25%(10/16) and 54 29%(18/35),respectively.Amiodarone could be used effectively for cardioversion and maintenance of sinus rhythm of the patients who failed to respond to lidocaine.Conclusions:Amiondarone is one of the effective drugs for patients with malignant ventricular arrhythmias,and amiodarone can be used effectively in patients who fail to response to other drugs.