胺碘酮预防心脏手术再灌注心室颤动的疗效  

Efficacy of amiodarone in preventing reperfusion ventricular fibrillation in patients undergoing cardiac surgery

作　　者：熊斌[1] 何立敏[2] Xiong Bin;He Limin(Department of Critical Care Medicine,the Second Affiliated Hospital,Chongqing Medical University,Chongqing 400010,China;Department of Cardiology,the First Branch of the First Affiliated Hospital,Chongqing Medical University,Chongqing 400015,China)

机构地区：[1]重庆医科大学附属第二医院重症医学科,400010 [2]重庆医科大学附属第一医院第一分院心内科,400015

出　　处：《中华胸心血管外科杂志》2021年第3期168-172,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：重庆市科卫联合医学科研项目(防疫一线医务人员项目,2020FYYX212)。

摘　　要：目的探讨胺碘酮预防心脏手术再灌注心室颤动(RVF)的疗效。方法计算机检索知网、万方、维普、Cochrane、Embase、Web of Knowledge和PubMed等数据库,搜索胺碘酮预防心脏手术患者RVF的相关研究,时间截至2019年12月。按照既定标准使用Revman 5.3软件进行meta分析。结果共纳入6项研究,包括514例患者。按照干预方式不同分为胺碘酮组196例、利多卡因组153例和对照组165例。RVF发生率比较,胺碘酮组显著低于对照组,差异有统计学意义(RR:0.64,95%CI:0.47~0.86,P=0.003,I^(2)=49%);但胺碘酮组和利多卡因组间差异无统计学意义(RR:1.03,95%CI:0.48~2.22,P=0.94,I^(2)=74%)。RVF除颤次数比较,胺碘酮组比对照组少,但差异无统计学意义(RR:0.90,95%CI:0.68~1.20,P=0.48,I^(2)=0);利多卡因组和胺碘酮组间差异亦无统计学意义(RR:1.50,95%CI:0.90~2.52,P=0.12,I^(2)=38%)。结论胺碘酮有助于减少心脏手术患者的RVF发生率。Objective To evaluate the efficacy of amiodarone in preventing reperfusion ventricular fibrillation(RVF)in patients undergoing cardiac surgery.Methods This study searched the databases of CNKI,Wanfang,Weipu,Cochrane,Embase,Web of Knowledge and PubMed,and searched the related research of amiodarone to prevent RVF in cardiac surgery patients,the time was until December 2019.Meta analysis was performed using Revman 5.3 software according to established standards.Results The study included six studies(incorporating 514 patients).According to different intervention methods,514 patients were divided into three groups,196 in the amiodarone group,153 in the lidocaine group,and 165 in the placebo group.The incidence of RVF was significantly lower in the amiodarone group than in the control group(RR:0.64,95%CI:0.47-0.86,P=0.003,I^(2)=49%),but there was no significant difference between the amiodarone group and the lidocaine group(RR:1.03,95%CI:0.48-2.22,P=0.94,I^(2)=74%).Compared with the control group,amiodarone reduced the defibrillation frequency of RVF,but the difference was not statistically significant(RR:0.90,95%CI:0.68-1.20,P=0.48,I^(2)=0).There was no difference in the number of defibrillation of RVF between the lidocaine group and the amiodarone groups(RR:1.50,95%CI:0.90-2.52,P=0.12,I^(2)=38%).Conclusion Compared with the control group,amiodarone can significantly reduce the incidence of RVF in patients undergoing cardiac surgery.

关 键 词：胺碘酮 再灌注心室颤动 心脏外科手术 META分析 

分 类 号：R654.2[医药卫生—外科学]