胺碘酮维持二尖瓣狭窄伴心房纤颤经皮二尖瓣球囊成形术后窦性心律的疗效  

Effect of Amiodarone on Maitaining the Sinus Rhythem of Cases of Rheumatic Mitral Stenosis and Atrial Fibrillation after Percutaneous Ballon Mitral Valvuoplasty

作　　者：高文献[1] 尤润生[1] 张光征[1] 闫培泉[1] 郭京东[1] 朱孔荣[1] 

机构地区：[1]山东省临沂市沂水中心医院心内科,276400

出　　处：《中国介入心脏病学杂志》1998年第1期28-30,共3页Chinese Journal of Interventional Cardiology

摘　　要：对二关瓣狭窄伴心房纤颤（简称二狭房颤）行经皮二尖瓣球囊成形术（PBMV）成功后的64例患者，术后即给予胺碘酮0．2g，3次／日×7天，未复律者给予经体表直流电复律，复律后随机分为胺碘酮0．4g／日维持量组和am0．2／日维持量组各32例。结果；单纯眼药1周转复窦性心律14例，余50例经直流电复律全部成功，复律后心功能均明显改善，随访21．60±12．3个目，16例心房纤颤复发。心房纤颤病程长，左房扩大明显者易复发，PBMV效果不佳（瓣口面积扩大程度小和左房四缩差）和术后再狭窄也是复发的重要因素，胺碘酮剂量小（0．2／日维持）易复发，故建议应用胺碘酮0．4／日维持。Sixty-four cases of rheumatic mitral stenosis and atrial fibrillation received cardioversion treatment after percutaneous bation mitral valvuloplasty (PBMV) were given amiodarone (Am) 0. 2 tid for seven days. Fourteen of them successfully returned to sinus rhythem. The other fifty without successful cardioversion were treated with current electrical defibrillation and all succeeded. The heart function of all cases improved markedly after successful cardioversion. Then the whole sixty-four cases were randonized into two groups,each with thirty-two,the former one took Am 0. 2 bid while the latter one took Am 0. 2 qd. A follow-up of 21. 6 ± 12. 3 months was made and sixteen had recurrence of atrial fibrillation. The cases with the following factors were likely to relapse,①remarkable eviargement of left atrium,②small mitral area after PBMV, ③restenosis after PBMV. The cases received Am 0. 2 qd for maintenance dosage were even more susceptible to recur than cases received Am 0. 2 bid. Soit was recommended that Am 0. 2 bid be the preferable maitenance dosage.

关 键 词：胺碘酮 二尖瓣狭窄 心房纤颤 球囊瓣膜成形术 

分 类 号：R654.2[医药卫生—外科学]