胺碘酮和索他洛尔治疗心脏病胸外手术室性心律失常疗效分析

Efficacy of amiodarone and sotalol in the treatment of symptomatic ventricular arrhythmias in patients with thoracic surgery for heart disease

目的对比胺碘酮和索他洛尔对器质性心脏病胸外手术患者术中症状性室性心律失常的治疗效果,探讨更有效的用药方式。方法回顾性分析2014年10月至2017年10月昆明医科大学第二附属医院收治的306例心脏病胸外手术治疗中发生症状性室性心律失常的器质性心脏病患者,根据用药的不同分为胺碘酮组(n=133)和索他洛尔组(n=173)。比较2组疗效、各型室性心律失常期前收缩负荷、症状发作频率、QT离散度(QTd)和校正QT离散度(QTcd)。结果药物治疗后,胺碘酮组治疗总有效率高于索他洛尔组,差异有统计学意义(P <0. 05);胺碘酮组的室性期前收缩、非持续性室速期前收缩负荷低于索他洛尔组(P <0. 05);胺碘酮组症状发作频率、QTd、QTcd、平均心率均低于索他洛尔组,差异有统计学意义(P <0. 05)。结论胺碘酮治疗器质性心脏病胸外手术中室性心律失常效果良好,可有效改善患者临床症状。

Objective To observe the treatment effect of amiodarone and sotalol on intraoperative symptomatic ventricular arrhythmia in patients with thoracic surgery for organic heart disease,and to explore more effective ways of medication. Methods A retrospective analysis was conducted on 306 patients with organic heart disease who were admitted into the second affiliated hospital of Kunming medical university from October 2014 to October 2017 and developed symptomatic ventricular arrhythmia during thoracic surgery for heart disease. According to different medications,the patients were divided into the amiodarone group ( n =133) and the sotarol group ( n =173). The curative effect, pre-systolic load in each type of ventricular arrhythmia,frequency of symptoms,QT dispersion ( QTd) and corrected QT dispersion ( QTcd) of the two groups were compared. Results After drug treatment,the total effective rate of the amiodarone group was higher than that of the sotalol group ( P <0. 01). The ventricular premature contraction and non-sustained ventricular pre-systolic contraction in the amiodarone group were lower than those in the sotalol group ( P <0. 05). The frequency of symptom onset,QTd,QTcd and mean heart rate in the amiodarone group were lower than those in the sotalol group ( P <0. 05). Conclusion The effect of amiodarone is good for the treatment of intraoperative symptomatic ventricular arrhythmia in patients with organic heart disease undergoing thoracic surgery,and it can effectively improve the clinical symptoms of patients.