围术期患者发生心室电风暴的急救处理及疗效分析

Emergency treatment and efficacy analysis of patients with ventricular electrical storm during perioperative period

目的总结6例手术患者在围术期发生心室电风暴(VES)的抢救治疗经验。方法根据患者术前、术中的基本情况,回顾性分析2019年2月~2023年6月6例患者在术中或术后发生VES的原因、救治方法及患者的转归。结果6例患者经过心肺复苏术(CPR)、电除颤以及应用胺碘酮、艾司洛尔、肾上腺素、去甲肾上腺素、利多卡因等多种血管活性药物,均抢救成功,无神经并发症,均治愈出院。结论6例手术患者在围术期发生VES可能与手术、麻醉、内环境严重紊乱或感染等多因素引起心脏交感风暴有关,通过去除病因、CPR、电除颤和合理使用上述血管活性药物等处理,有利于恢复心脏的供血、供氧,保证心肌氧气供需平衡,达到抢救成功的目的。

Objective To summarize the experience of rescue and treatment of ventricular electrical storm(VES)in 6 patients undergoing surgery during perioperative period.Methods To retrospectively analyse the cause of VES of 6 patients during the perioperative period,treatment methods and the prognosis from February 2019 to June 2023,according to the basic condition of patients during the pre-operative and perioperative period.Results 6 patients with VES had been successfully rescued after cardiopulmonary resuscitation(CPR),electric defibrillation and reasonably application of vasoactive drugs such as amiodarone,esmolol,adrenaline,noradrenaline and lidocaine.All patients were rescued and discharged without neurological complications.Conclusion It was possible that 6 patients with VES during perioperative period had related to do with operation,anesthesia,severe internal environment disorder or severe infection,which led to the cardiac sympathetic storm.It is beneficial to restore the blood supply and oxygen supply of the heart,ensure the balance of supply and demand of myocardial oxygen,and achieve the purpose of successful rescue by removing the etiology,CPR,defibrillation and rational use of the the above vasoactive drugs.