急诊大剂量应用可达龙治疗顽固性恶性室性心律失常疗效及安全性的临床研究  

Clinical research of curative effect and security of refractoriness and malignant ventricular arrhythmia cured with large dose Amiodarone in emergency cases

作　　者：刘明[1] 张红欣[2] 李波[1] 梁文波[1] 程宽[3] 李清[3] 

机构地区：[1]泰安市中心医院急救中心,山东泰安271000 [2]泰安卫校,山东泰安271000 [3]复旦大学附属医院,上海200000

出　　处：《泰山医学院学报》2005年第3期233-235,共3页Journal of Taishan Medical College

摘　　要：目的探讨并总结急诊应用大剂量可达龙(Amiodarone,Am),即胺碘酮治疗恶性顽固性室性心律失常的疗效及安全性的用药经验。方法选择对常规抗心律失常药物治疗无效的67例患者,男41例、女26例,年龄46.7±14.8(45~75)岁。静脉注射负荷量Am,3~5 mg/kg,用生理盐水稀释至20 ml,7~15 min内注入,继之以1.0~1.5 mg/min静脉泵入维持,若心律失常控制不满意时,每隔30 min后再静注75~150 mg。静脉应用同时口服可达龙600~1200 mg/d,用药2~8天,平均6天。结果第1个24 h可达龙静脉用量1678±285(1489~2316)mg。27例顽固性心律失常24 h内获得完全控制(显效),37例36 h^60 h得以控制(有效),其中2例并用电复律成功,1例因心源性休克死亡。结论急诊大剂量静脉应用可达龙治疗顽固性恶性室性心律失常疗效佳,安全性好,副作用少,值得推广应用。Objective： To investigate and summarize some curative effect and security of refractory and malignant ventricular arhythmia arrhythrnia treated with large dose of amiodarone. Methods： Sixty-seven cases of refractory patients, 41 males and 26 females average age： 46.7±14.8（45～75）, who had not been treated effectively with routine drugs, were treated with Amiodarone. The patients were treated with the dose （3～5 mg per kg） of amiodarone attenuated to 20 ml with isotonic Na chloride intravenous injection within 7～15 minutes. Then amiodarone was intravenously injected to maintain within 1.0～1.5 mg per minute with venous pump. If arhythrnia was not controlled, amiodarone was intravenously injected every 30 minutes. Simultaneously the patents orally received amiodaronum 600～1200 mg per day, lasting 2～8 days, with an average of 6 days. Results： The amiodaronum 1678±285（1489～2316）mg was used in the first day （24 hours）, and 27 cases malignant ventrieular arhythmia were obviously controlled, 37 cases were in some way. One of them was dead because of cardiac shock, and two cases were rescued with electrical conversion. Conclusion The large dose of Amiodarone is effective in the emergency cases of emalignant ventricular arrhythmia and it is safe and has no side-effect and can be applied.

关 键 词：室性早搏 室性心动过速 心室颤动 胺碘酮 临床研究 

分 类 号：R541.7[医药卫生—心血管疾病]