急性心肌梗死后心室电风暴6例临床分析  

Clinical analysis on 6 cases with ventricle electrical storm after acute myocardical infarction

作　　者：马春艳[1] 赵伟男[1] 

机构地区：[1]中国人民解放军第251医院心内科,河北省张家口市075000

出　　处：《中国心血管病研究》2010年第3期198-200,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的通过对6例急性心肌梗死后心室电风暴（VES）抢救治疗患者的资料分析，总结早期识别和抢救VES的经验。方法6例均为急性心肌梗死后反复室速／室颤的患者，6例均多次给予同步月#同步心脏电击复律／除颤、应用胺碘酮及倍他乐克联合抗心律失常、补钾、降压、抗冠状动脉炎症等改善心肌缺血综合治疗。结果其中5例转复成功；1例不能维持窦性节律，在主动脉球囊反搏下行急诊冠状动脉支架置入治疗后心室电风暴终止发作。6例患者长期服用胺碘酮、倍他乐克维持，门诊随访，1例因心力衰竭于18个月后死亡，其余5例至今存活。结论心脏同步月E同步电复律／除颤、胺碘酮及美托洛尔联合抗心律失常治疗急性心肌梗死后心室电风暴安全有效，但要注意基础病因治疗，转复后长期服用胺碘酮、倍他乐克预防复发。Objective To find ventricle electrical storm （VES） after acute myocardical infarction（AMI） earlier and sum up the experience of curing VES through analysis the data about emergency treatment of 6 cases with VES after AMI. Methods Synchronized and non-synchronized cardioverter-defibrillator for many times, antiarrhythmia with the combination of amiedarone and betaloc, supplement of potassium, decreasing blood presure, anti-inflammation and improvement myocardial ischemia were applied for treating 6 cases of recurrent ventricular tachycardia or fibrillation after AMI. Results 5 cases succeeded in conversion. 1 case could not maintain sinus rhythm, after implanting coronary stent by emergency with the support of intraaortic ballon reboundation, then the attack stopped. 6 cases took long-term amiodarone and betaloc. 5 cases were still alive and 1 case died of heart failure 18 months later during followed-up period. Conclusion Synchronized or non-synchronized cardioversion/ defibrillation, antiarrhythm with the combination of amiodaron and metoprolol were safe and effective in treating of VES after AMI, but the treatment of underlying cardiac disease needed paying attention, and the recurrence would be prevented with oral amoidarone and betaloc long-term after conversion of VES.

关 键 词：心肌梗死 心室电风暴 

分 类 号：R542.22[医药卫生—心血管疾病]