静脉泵注大剂量胺碘酮转复阵发性房颤109例疗效分析  

Analysis of the effects of high-dose amiodarone on cardioversion of paroxysmal atrial fibrillation in 109 patients

作　　者：成娟 王宏 刘敏 庞延友 沈宁阳 吉静 王福杰 

机构地区：[1]辽阳石化总医院内科, 辽宁省辽阳111003

出　　处：《中华急诊医学杂志》2014年第4期426-428,共3页Chinese Journal of Emergency Medicine

摘　　要：目的 观察大剂量胺碘酮持续静脉泵注转复阵发性房颤的有效性和安全性.方法 2008-2010年3年间辽阳石化总医院收治的阵发性房颤患者109例,应用大剂量胺碘酮（125mg/h）持续静脉泵注转律治疗.转律前均给予低分子肝素抗凝治疗,化验FT3、FT4、TSH、血清离子等,做心脏彩超,行心电、血压监护;应用盐酸胺碘酮注射剂（可达龙）150mg加入0.9％的氯化钠50 mL中混匀,以41 mL/h速度持续泵注,即胺碘酮125mg/h,直至转复为窦性心律或达24h;转复后视情况改用0.5～1 mg/min维持6～12 h并加用胺碘酮口服,24h内静脉用胺碘酮总量不超过3000 mg.结果 104例转为窦性心律,成功率为95.41％,胺碘酮的转复剂量为（774.52＆#177;700.53） mg,转复时间（6.34＆#177;5.55）h.结论 阵发性房颤患者应用大剂量胺碘酮（125 mg/h）持续静脉泵注转律治疗具有转复成功率高、并发症和不良反应少等优点,在基层医院有广阔的应用前景.Objective To observe the efficacy and safety of high-dose amiodarone administered by continuously intravenous infusion for cardioversion of paroxysmal atrial fibrillation.Methods From 2008 to 2010,109 patients suffered from paroxysmal atrial fibrillation were treated with high-dose arniodarone （125 mg/h） administered by continuously intravenous infusion.Before cardioversion,patients were treated with low molecular weight heparin anticoagulant therapy,Laboratory tests on FT3,FT4,TSH,serum ions,etc,and coloured Doppler ultrasound imaging of heart,and ECG and blood pressure monitoring were carried out.Amiodarone hydrochloride injectio of 150 mg was mixed with sodium chloride 50 mL homogeneously,and then infused continuously by micro-pump in a rate of 41 mL/h until resume of sinus rhythm or infusion was kept up to 24 h.After successful cardioversion,as appropriate,the intravenous amiodarone was maintained in a rate of 0.5-1.0 mg/min for 6-12 h joined with oral amiodarone dosing,and the total dose was limited up to 3000 mg.Results A cohort of 104 （95.4%） patients had the restoration of sinus rhythm after cardioversion.The mean dose of amiodarone for cardioversion was （774.52 t 700.53） mg,and time required for cardioversion was （6.3 ＆#177; 5.55） hours.Conclusions The patients with paroxysmal atrial fibrillation are given high-dose amiodarone （125 mg/h） continuously intravenous infusion therapy and have high cardioversion success rate,less complications and side effects,as well as other advantages at the basic hospital.The method above has broad application prospects.

关 键 词：胺碘酮 大剂量 持续静脉泵注 阵发性房颤 转律 

分 类 号：R541.75[医药卫生—心血管疾病]