胺碘酮与普罗帕酮对阵发性室上性心动过速的临床急诊救治效果

Clinical emergency treatment effect of amiodarone and propafenone on paroxysmal supraventricular tachycardia

目的探讨胺碘酮与普罗帕酮急诊救治阵发性室上性心动过速的临床疗效。方法选取2019年11月至2020年11月本院急诊接收的102例阵发性室上性心动过速患者作为研究对象,根据不同药物治疗方案分为普罗帕酮组和胺碘酮组,每组51例。普罗帕酮组接受普罗帕酮药物治疗,胺碘酮组接受胺碘酮治疗,比较两组心室负荷与心率、临床疗效、复律成功率、复律时间及不良反应发生情况。结果治疗后,两组左室射血分数、左室收缩末容积均高于治疗前,心率、左室舒张末容积均低于治疗前,差异有统计学意义(P<0.05);但治疗前后,两组组间左室射血分数、心率、左室收缩末容积、左室舒张末容积比较差异无统计学意义。两组复律成功率、治疗总有效率比较差异无统计学意义。普罗帕酮组复律时间短于胺碘酮组,差异有统计学意义(P<0.05)。胺碘酮组不良反应发生率为5.88%,低于普罗帕酮组的23.53%,差异有统计学意义(P<0.05)。结论普罗帕酮与胺碘酮救治阵发性室上性心动过速均有效,有助于患者复律,改善患者心室负荷及心率;普罗帕酮复律快、见效迅速,但不良反应较多;胺碘酮复律慢,但不良反应少,具有较高的安全性,临床急诊救治阵发性室上性心动过速患者时,应根据患者具体病情合理用药,以保障治疗安全性。

Objective To investigate the clinical efficacy of amiodarone and propafenone in emergency treatment of patients with paroxysmal supraventricular tachycardia.Methods 102 patients with paroxysmal supraventricular tachycardia received in the Emergency Department of our hospital from November 2019 to November 2020 were selected as the study subjects,and they were divided into propafenone group and amiodarone group according to different drug treatment schemes,with 51 cases in each group.The propafenone group received propafenone treatment,and the amiodarone group received amiodarone treatment,the ventricular load,heart rate,clinical effect,cardioversion success rate,cardioversion time and adverse reactions were compared between the two groups.Results After treatment,the left ventricular ejection fraction and left ventricular end-systolic volume in the two groups were higher than those before treatment,and the heart rate and left ventricular end-diastolic volume were lower than those before treatment(P<0.05);however,before and after treatment,there was no significant difference in left ventricular ejection fraction,heart rate,left ventricular end-systolic volume and left ventricular end-diastolic volume between the two groups.There was no significant difference in the success rate of cardioversion and the total effective rate of treatment between the two groups.The cardioversion time of propafenone group was shorter than that of the amiodarone group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the amiodarone group was 5.88,which was lower than 23.53%in the propafenone group,and the difference was statistically significant(P<0.05).Conclusion Both propafenone and amiodarone are effective in the treatment of paroxysmal supraventricular tachycardia,which is helpful to restore the rhythm and improve the ventricular load and heart rate of patients;Propafenone cardioversion is fast and effective,but has many adverse reactions,while amiodarone cardioversion is slow,but has few adverse reactions and has high safety,clinical emergency treatment of paroxysmal supraventricular tachycardia patients,rational medication should be used according to the specific conditions of the patients to ensure the safety of treatment.