急诊快速型心律失常58例临床诊疗效果分析

Clinical analysis of 58 cases of emergency treatment of tachyarrhythmia

目的探讨急诊快速型心律失常患者的临床治疗方法、效果及不良反应。方法回顾性分析2015年1月-2017年12月间因快速型心律失常就诊于本院急诊的58例患者临床资料,观察快速型心律失常患者一般资料、心律失常类型、治疗方法、用药情况及治疗效果等临床特征。结果58例患者中,男性31例,女性27例;房颤36例(62.2%)、室上性心动过速9例(15.5%)、室性心动过速6例(10.3%)、房性心动过速2例(3.4%)、心房扑动5例(8.6%);所有患者均使用了抗心律失常药物,用药最多为胺碘酮(55.2%),其次为普罗帕酮(13.8%)、西地兰(12.1%)和艾司洛尔(8.6%)。房颤、室上速、房扑、室性心动过速治疗用药以胺碘酮为主;胺碘酮治疗后产生不良反应2例(3.4%),其中窦性行动过缓1例,低血压1例。结论急诊快速型心律失常患者治疗难度大,常需要联合用药,其中胺碘酮治疗急诊快速型心律失常具有显著临床疗效,宜广泛推广使用。

Objective To investigate the clinical treatment,effect and adverse reactions of patients with rapid arrhythmias in emergency.Methods Clinical data of 58 patients with rapid arrhythmias treated with emergency treatment in our hospital from January2015 to December 2017 were analyzed retrospectively,and the general data,arrhythmias types,treatment methods,drug use and treatment effects of rapid arrhythmias were observed.Results Among the 58 patients,31 were male and 27 were female.36 cases were atrial fibrillation(62.2%),9 cases were supraventricular tachycardia(15.5%),6 cases were ventricular tachycardia(10.3%),2 cases were atrial tachycardia(3.4%),and 5 cases were atrial palpitation(8.6%).All patients were treated with anti-arrhythmias,up to the maximum of amiodarone(55.2%),followed by proparenone(13.8%),Aisiluoer(12.1%),and Amoxidine(8.6%).The main drugs of atrial fibrillation,ventricular tachycardia,atrial flutter,and ventricular tachycardia were amiodarone.There were 2 cases(3.4%)of adverse reactions after amiodarone treatment,including 1 case of sinus hypotension and 1 case of hypotension.Conclusion The treatment of acute rapid arrhythmias is difficult and often needs to be combined.Amiodarone has significant clinical effect in the treatment of acute rapid arrhythmias and should be widely used.