静脉艾司洛尔治疗快速性室性心律失常的临床观察  

Clinical observation of intravenous esmolol for the treatment of rapid ventricular arrhythmia

作　　者：江明宏[1] 舒茂琴[2] 刘亚忠[1] 侯聪聪[1] 曹雪滨[1] 

机构地区：[1]解放军252医院心内科全军心血管介入中心,河北保定071000 [2]重庆市第三军医大学西南医院心内科,重庆400038

出　　处：《岭南心血管病杂志》2014年第1期68-70,110,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨艾司洛尔治疗快速性室性心律失常的临床疗效及安全性。方法 2011年1月至2012年12月在解放军252医院心内科住院的49例患者,在住院期间发生快速室性心律失常,年龄(61.72±3.32)岁。分为两组:单纯艾司洛尔组为电复律或电除颤+艾司洛尔(26例);联合艾司洛尔组为电复律或电除颤+盐酸胺碘酮+艾司洛尔(23例)。结果联合电复律或电除颤治疗,单纯艾司洛尔组有效率96%(25/26),在胺碘酮无效的基础上或同时加用静脉艾司洛尔,有效率69.5%(16/23),单纯艾司洛尔组终止交感风暴的成功率显著高于胺碘酮组,差异有统计学意义(P<0.05)。艾司洛尔给药后室性心动过速或心室颤动复发次数明显减少,相应除颤次数较常规组少;未发生不能维持的低血压状态和严重缓慢性心律失常。结论及时的电复律或电除颤和使用β受体阻断药艾司洛尔,可有效控制快速性室性心律失常的发作。Objectives To investigate the clinical efficacy and safety of esmolol in treatment of rapid ventricular arrhythmias.Methods There were 49 patients who suffered from rapid ventricular arrhythmia during hospitalization from January 2011 to December 2012 in PLA 252 Hospital.Average age was （61.72±3.32） years old.These patients were divided into two groups：esmolol alone group （patients were treated with cardioversion or defibrillation＋esmolol,n=26） and combination group （patients were treated with cardioversion or defibrillation＋amiodarone hydrochloride＋esmolol,n=23）.Results With electrical cardioversion or electrical defibrillation therapy,efficiency of esmolol alone group was 96％ （25/26）;If amiodarone was ineffective,we combined with intravenous esmolol to terminate rapid ventricular arrhythmias,thus the efficiency reached 69.5％ （16/23）.The success rate of esmolol alone group which terminated sympathetic storm was significantly higher than that of amiodarone group （P＜0.05）.Recurrence of ventricular tachycardia or ventricular fibrillation afrer esmolol treatment was significantly lower,the corresponding defibrillations were less.There was no occurrence of hypotension that could not be corrected or severe slow arrhythmia.Conclusions Timely cardioversion or defibrillation with β-blocker （esmolol） can effectively control rapid ventricular arrhythmia.

关 键 词：心律失常 室性心律 Β受体阻断药 艾司洛尔 

分 类 号：R541.7[医药卫生—心血管疾病]