改良瓦氏动作在阵发性室上性心动过速患者急诊转复中的应用  

Application of modified Valsalva maneuver in emergency cardioversion in patients with paroxysmal supraventricular tachycardia

作　　者：林文风 孙立琴 张小红 程宝珍 张国文 Lin Wenfeng;Sun Liqin;Zhang Xiaohong;Cheng Baozhen;Zhang Guowen(Department of Emergency Medicine,First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital),Hefei 230001,China)

机构地区：[1]中国科学技术大学附属第一医院(安徽省立医院)急诊医学科,合肥230001

出　　处：《中国循证心血管医学杂志》2021年第9期1121-1123,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的观察改良瓦氏(Valsalva)动作在阵发性室上性心动过速(PSVT)患者急诊转律中的应用效果。方法选取2017年8月至2020年1月于中国科学技术大学附属第一医院(安徽省立医院)急诊科收治的81例PSVT患者,采用随机数字表法分为观察组(41例)和对照组(40例)。观察组患者采用改良Valsalva动作行急诊转律治疗,对照组采用经典Valsalva动作治疗。观察两组患者转律过程中平均Valsalva动作治疗次数及转复成功率并记录治疗中的不良反应情况。结果观察组中18例成功转为窦性心律,复律成功率43.9%;对照组8例成功转为窦性心律,复律成功率20.0%,观察组明显高于对照组(P<0.05)。观察组中相关性不良事件率为7.5%,对照组为9.2%,两组差异无统计学意义(P>0.05)。结论改良的Valsava动作在阵发性室上性心动过速患者急性发作治疗时,转律成功率高,疗效确切,可作为急救的首选治疗手段。Objective To observe the application effect of modified Valsalva maneuver in emergency cardioversion in patients with paroxysmal supraventricular tachycardia(PSVT).Methods PSVT patients(n=81)were chosen from Department of Emergency Medicine in the First Affiliated Hospital of University of Science and Technology of China(Anhui Provincial Hospital)from Aug.2017 to Jan.2020,and divided randomly into observation group(n=41)and control group(n=40).The observation group was given emergency cardioversion by applying modified Valsalva maneuver,and control group was treated by applying classic Valsalva maneuver.The mean treatment times of modified Valsalva maneuver and success rate of cardioversion were observed,and adverse reactions were recorded during emergency cardioversion.Results In observation group,18 cases had successful conversion to sinus rhythm and success rate of cardioversion was 43.9%,and in control group,8 cases had successful conversion to sinus rhythm and success rate of cardioversion was 20.0%(P<0.05).The incidence rate of related adverse events was 7.5%in observation group and 9.2%in control group(P>0.05).Conclusion Modified Valsalva maneuver has a higher success rate of cardioversion and exact curative effect in PSVT patients during acute seizure phase,and it can be the first treatment for first aid.

关 键 词：阵发性室上性心动过速 改良Valsalva动作 急救 转律 

分 类 号：R541.7[医药卫生—心血管疾病]