胺碘酮在治疗冠状动脉架桥术后围术期新发快速房颤中的应用  

Use of Amiodarone to treat rapid atrial fibrillation after coronary artery bypass grafting

作　　者：李白翎[1] 侯霄雷[2] 张冠鑫[1] 徐志云[1] 黄盛东[1] 

机构地区：[1]第二军医大学附属长海医院胸心外科,上海200433 [2]上海中医药大学附属岳阳中西医结合医院ICU,上海200437

出　　处：《中国现代医学杂志》2007年第5期572-574,共3页China Journal of Modern Medicine

基　　金：军队"十五"重点课题(01z063)

摘　　要：目的研究静脉用胺碘酮治疗CABG术后围术期新发快速房颤的有效性和安全性。方法218例冠状动脉架桥术后患者(术前均为窦性心律)其中39例发生房颤,占17.89%,均采用胺碘酮经静脉治疗(静推3mg/kg。随后600～1200mg/d静脉持续泵入2～5d)。观察其转复窦性心律的效果及其不良反应。结果36例患者成功转复为窦性心律,总有效率为92.31%。发生不良反应共4例,占术后房颤患者总人数10.25%。心房纤颤转复为窦性心律前后动脉收缩压、舒张压、Q-T-C间期无统计学差异(P>0.05),心室率变化有显著统计学意义(P<0.01)。结论静脉应用胺碘酮治疗并发于冠状动脉架桥术后围术期新发快速房颤是有效且较安全的方法。[Objectives] To evaluate the efficacy and safety of intravenous amiodarone for AF after CABG. [Methods] 218 patients who underwent CABG were studied retrospectively. Including 39 patients occurred AF, accounting for 17.89%. All the patients who occurred AF after coronary artery bypass grafting （CABG） were given amiodarone. The first bolus of Amiodarone was given at 3 mg/kg intravenously followed by sustained infusion of 600-1 200 mg/d lasting 2-5 d. The efficacy was defined as returning to sinus rhythm （SR） during the trail. [Results] 36 patients returned to sinus rhythm （SR）, the total effective rates was 92.31%. The possible side effects were observed in 4 patients （10.25%）. After returned to sinus rhythm, the artery systolic pressure, the diastolic pressure, Q-T-C time have nonstatistical difference （P 〉 0.05）. The ventricle rate change has the remarkable statistical significance （P 〈 0.01）. [ Conclusion ] Intravenous Amiodarone is safe and effective in management of atrial fibrillation after CABG.

关 键 词：胺碘酮 冠状动脉架桥术 快速房颤 

分 类 号：R543.3[医药卫生—心血管疾病]