房颤或房扑病人行心内直视手术在主动脉开放后静脉注射胺碘酮的效用  

Intravenous Amiodarone Against Atrial Fibrillation or Flutter after Opening of Aorta in Open Heart Surgery

作　　者：陈伟[1] 姜桢[1] 

机构地区：[1]复旦大学附属中山医院麻醉科,上海200032

出　　处：《中国临床医学》2006年第3期485-486,488,共3页Chinese Journal of Clinical Medicine

摘　　要：目的：观察术前存在房颤或房扑病人行心内直视手术在主动脉开放后静脉注射胺碘酮的作用及对血流动力学的影响。方法：选择术前存在房颤和房扑病人行心内直视手术100例,随机分为胺碘酮组(A组,在主动脉开放、自主心跳已恢复、并减少腔静脉回流的部分循环始10min内经静脉推注胺碘酮150mg,其后24h静脉滴注10mg/kg)和对照组C组,将胺碘酮替换为安慰剂。监测心电图、桡动脉压(ASP)、中心静脉压(CVP)、心输出指数(CI)以及中心静脉压(CVP),随访术后情况。结果：房颤的转复率与房颤病史密切相关。两组心律转复成功率有显著差异(P＜0.05),且A组与C组比较心率较慢(P＜0.01),CVP较低(P＜0.05),CI较高(P＜0.05)而ICU滞留时间较短(P＜0.01)。结论：在主动脉开放且自主心跳已恢复后静脉给予胺碘酮,对原有房颤或房扑病人,心内直视手术后心律转复成功率有显著作用,并能更好控制心室率,从而达到较好稳定血流动力学的效果并改善病人的预后。Objective：To observe the effect of intravenous amiodarone after opening of aorta in open heart surgery patients with atrial fibrillation（Af） or flutter（AF）. Methods：One hundred patients with Af or AF under open heart surgery were randomly divided into two groups. In A group, patients were administrated bolus of 150mg after open of aorta then following with 10 mg·kg^-1·d^-1. Others were given placebo. Cardioversion were performed in those patients. The data of hemodynamic and ECG were monitored and recorded. Results：No statistical differences were noted in baseline variables. 28 patients could be converted to sinus rhythm. There is significant difference on conversion between two groups（P〈0. 05）. Heart rate was slower in group A （P〈0.01）, but CI was higher （P〈0.05） compared with group C. Patients in group A had shorter time to stay in ICU because of more stable in hemodynamics. Conclusion： Intravenous amiodarone after opening of aorta in open heart surgery could promote the conversion of Af or AF and also helped to achieve more stable hemodynamics. Then promote prognosis.

关 键 词：胺碘酮 房颤 心内直视手术 

分 类 号：R645.2[医药卫生—外科学]