继发于危重症的室速风暴及其治疗  

Treatment of ventricular tachycardia storm secondary to critical illness

作　　者：张群英[1] 牛云茜[1] 陈柏荣[1] 

机构地区：[1]中山大学附属第五医院心内科,广东广州519000

出　　处：《中国医药导报》2008年第31期10-12,共3页China Medical Herald

摘　　要：目的:观察静脉应用β-受体阻滞剂治疗室速风暴的临床疗效及其安全性。方法:2005年1月～2008年1月我院收治的室速风暴患者41例,随机分为对照组和倍他乐克干预组。其中,对照组26例患者仅于静脉应用利多卡因或胺碘酮基础上采用电复律治疗;倍他乐克干预组15例患者在上述治疗基础上静脉给予倍他乐克。结果:倍他乐克干预组终止反复室速、室颤成功率显著高于对照组(93.33%vs34.61%,P<0.05),终止室速及室颤所需放电次数[(4.27±1.28)次]显著少于对照组[(7.77±3.46)次,(P<0.05)]。倍他乐克干预组房室传导阻滞的发生率显著高于对照组(33.33%vs3.85%,P<0.05)。对照组与倍他乐克干预组低血压(57.69%vs73.33%)及交界性或室性逸搏(61.54%vs73.33%)的发生率无显著差异(P>0.05)。结论:对于继发于危重症的反复性室速和室颤应认识到有交感风暴的存在,常规治疗基础上,及时、足量地静脉注射β-受体阻滞剂治疗室速风暴是非常有效而且安全的。Objective： To evaluate the effect of β-blocker on ventricular tachycardia storm. Methods： 41 patients of ven- tricular tachycardia storm were randomly divided into two groups from January 2005 to January 2008： control group and Betaloc intervention group. Patients in control group were treated with Lidocaine or Amiodaronehydrochloride and electric cardioversion; patients in Betaloc intervention group were intravenously administrated with Betaloc Injection on the basis of the treatment of control group. Results： The success rate of terminating repeated ventricular tachycardia or ventricular fibrillation of Betaloc intervention group was significantly higher than that of control group （93.33% vs 34.61%, P〈0.05）, and its necessary discharge times of terminating ventricular tachycardia or ventricular fibrillation were considerably decreased than those in control group （4.27±1.28 vs 7.77±3.46, P〈0.05）. The incidence of atrioventricular block in Betaloc intervention group was markedly increased compared with that in control group （33.33% vs 3.85%, P〈0.05）. No significant difference was found in the incidence of hypotension（57.69% vs 73.33%）, A-V junctional escape rhythm or ventricular es- cape rhythm （61.54% vs 73.33%） in patients of both groups （P〉0.05）. Conclusion： It is important to be aware of the exis- tence of ventricular tachycardia storm secondary to critical illness. On the basis of conventional treatment, intravenous ad- ministration of β-blocker injection is a safe and effective therapy to ventricular tachycardia storm.

关 键 词：Β-受体阻滞剂 室性心动过速 心室颤动 交感风暴 

分 类 号：R541.7[医药卫生—心血管疾病]