急性心肌梗死早期再灌注性心室颤动  

The clinical study of early perfusion ventricular fibrillation in acute myocardial infarction

作　　者：徐泽升[1] 刘书旺[1] 韩立宪[1] 王贵松[1] 李红梅[1] 李晓梅[1] 元柏民[1] 

机构地区：[1]河北省沧州市中心医院心内科,061001

出　　处：《临床心电学杂志》2000年第2期83-85,共3页Journal of Clinical Electrocardiology

摘　　要：目的　探讨再灌注性心室颤动 ( RVF)易发因素、治疗及预后。方法　 35 8例接受再灌注疗法的急性心肌梗死 ,其中静脉溶栓 32 2例 ,急症 PTCA36例 ,临床再通者 2 2 1例 ,其中溶栓组 186例 ,急症 PT-CA组 35例 ,临床再通者有 7例发生 RVF,其中溶栓组 6例 ,急症 PTCA组 1例。结果　 7例 RVF平均年龄为 41.6± 2 .8岁 ,胸痛至再灌注时间为 3.2± 0 .8小时 ,RVF发生前多无恶性心律失常等先兆 ,闭塞部位于冠状动脉近端 ,开通后残余轻 ,随访 2 3.3月无心室颤动复发。结论　心肌梗死时缺血范围大 ,再灌注时间早 ,再灌注流量大 ,是 RVF的易发因素 ,电转复是有效的治疗方法。随访期间无心室颤动复发 。Objective To study the susceptive factors of reperfusion ventricular fibrillation (RVF) to guite the treatment and the prognosis.Methods RVF was defined as the VF occuring immediately and within 30 minutes after reperfusion therapy.358 patients received reperfution therapy,intravenous thrombolysis group 322,urgent PTCA group 36.221 Patients in 358 successfully reperfused,thrombolysis 186,PTCA 35.7 patients in 221 occured RVF,thrombolysis 6,PTCA 1.Results The mean age of the 7 cases was 41.6±2.8 years.The time from chest pain onset to reperfution was 3.2±0.8 hours.There was no presage like malignant arrhythmias before occurence of RVF.The occlusion site were all located at the proximal segments of coronary arteris.No VF reoccured during 23.3 month follow up.Conclusion Large ischemic size,early reperfusion time and big reperfusion flow were susceptive factors to RVF after acute myocardial infarction.Defibrillation was an effective method for RVF.All the patients had no reocurrene of VF and a good progrosis during follow up period.

关 键 词：急性心肌梗死 再灌注 心室颤动 

分 类 号：R542.22[医药卫生—心血管疾病]