胺碘酮联合利多卡因治疗急性心梗伴室性心律失常的临床疗效

Amiodarone Combined with Lidocaine in the Treatment of Acute Myocardial Infarction with Ventricular Arrhythmia

目的观察胺碘酮联合利多卡因在急性心梗伴室性心律失常中的临床疗效。方法选择2018年1月~2019年6月在我院治疗的急性心梗伴室性心律失常患者110例,采用随机数字表法分为对照组和观察组,各55例,对照组采用利多卡因治疗,观察组在对照组基础上联合胺碘酮治疗,比较两组临床治疗总有效率、QT离散度(QTd)、Q-T间期(QTc)、治疗期间心房颤动、心房扑动、阵发性室上速以及不良反应发生情况。结果观察组治疗总有效率为96.36%,高于对照组的81.81%,差异有统计学意义(P<0.05);观察组治疗期间心律失常总发生率为3.63%,低于对照组的23.63%,差异有统计学意义(P<0.05);治疗后两组QTd均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);观察组QTc高于治疗前,对照组QTc低于治疗前,但差异无统计学意义(P>0.05),观察组QTc高于对照组,差异有统计学意义(P<0.05);观察组临床不良反应发生率为5.45%,低于对照组的21.81%,差异有统计学意义(P<0.05)。结论胺碘酮联合利多卡因治疗急性心梗伴室性心律失常效果确切,有助于促进心电稳定,且临床不良反应少,用药安全,值得借鉴。

Objective To observe the clinical efficacy of amiodarone combined with lidocaine in acute myocardial infarction with ventricular arrhythmia.Methods A total of 110 patients with acute myocardial infarction and ventricular arrhythmias treated in our hospital from January 2018 to June 2019 were selected.They were divided into a control group and an observation group using random number table method,each of which was 55 cases.The control group was treated with lidocaine,and the observation group was combined with amiodarone treatment on the basis of the control group to compare the total clinical efficacy,QT dispersion(QTd),Q-T interval(QTc),atrial fibrillation and atrial during treatment Flutter,paroxysmal supraventricular tachycardia,and adverse reactions.Results The total effective rate of treatment in the observation group was 96.36%,higher than 81.81%in the control group,the difference was statistically significant(P<0.05);the total incidence of arrhythmia during the treatment in the observation group was 3.63%,lower than 23.63%in the control group,the difference was statistically significant(P<0.05);after treatment,the QTd of both groups was lower than before treatment,and the observation group was lower than the control group,the difference was statistically significant(P<0.05);the observation group QTc was higher than before treatment,the QTc of the control group was lower than before treatment,but the difference was not statistically significant(P>0.05),the QTc of the observation group was higher than the control group,the difference was statistically significant(P<0.05);the incidence of clinical adverse reactions in the observation group was 5.45%,it was lower than 21.81%of the control group,the difference was statistically significant(P<0.05).Conclusion Amiodarone combined with lidocaine is effective in the treatment of acute myocardial infarction with ventricular arrhythmia,and it can promote the stability of ECG.It has few clinical adverse reactions and is safe to use.It is worth learning.