同步电复律及胺碘酮用于中青年室上性心动过速院外急救的价值  

The value of synchronous electrical cardioversion and amiodarone in prehospital first aid for young and middle-aged patients with supraventricular tachycardia

作　　者：王坤[1] 严浩[1] 张玲[1] 杨萍芬[1] WANG Kun;YAN Hao;ZHANG Ling;YANG Pingfen(Beijing Emergency Center,Beijing 100031,China)

机构地区：[1]北京急救中心西城急救中心站,北京100031

出　　处：《中国急救复苏与灾害医学杂志》2022年第11期1426-1429,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：北京市科技计划项目(编号:Z191100004419003)。

摘　　要：目的探讨同步电复律及胺碘酮用于中青年室上性心动过速院前急救的价值。方法选取2019年6月—2021年6月北京急救中心西城急救中心站急救的106例室上性心动过速患者,年龄47~57岁,随机分为两组:对照组静脉注射胺碘酮150 mg,观察组静脉注射胺碘酮后进行同步电复律治疗。比较两组患者的复律成功率、复律时间、治疗期间的不良反应及治疗前后平均心室率、QT间期,在治疗前和复律后使用彩色多普勒诊断仪测量左室射血分数(LVEF)、左室舒张末期内径值(LVDD)。结果观察组复律成功率为84.91%,与对照组相比差异无统计学意义(88.68%,P>0.05),观察组复律时间为(10.16±5.34)min,明显短于对照组[(21.23±8.41)min,P<0.05];两组治疗前后LVEF、LVDD水平、平均心室率、QT间期比较差异无统计学意义(均P>0.05);但观察组治疗后LVEF显著高于同组治疗前,观察组治疗后LVDD显著低于同组治疗前(均P<0.05);且两组治疗后平均心室率显著低于治疗前(均P<0.05)。结论同步电复律及胺碘酮用于中青年室上性心动过速院前急救有较好的临床价值,治疗效果较好,复律迅速,安全性高。Objective To explore the clinical value of synchronous electrical cardioversion and intravenous injection of amiodarone in prehospital first aid for young and middle-aged patients with supraventricular tachycardia.Methods 106 patients with supraventricular tachycardia,aged 47~57,were randomly divided into 2 equal groups:control group receiving intravenous injection of amiodarone150 mg,and observation group receiving synchronous electrical cardioversion after intravenous injection of amiodarone in addition.The success rate of cardioversion,cardioversion time,adverse reactions during treatment,average ventricular rate,and levels of QT interval before and after treatment were compared between the two groups of patients.Color Doppler diagnostic apparatus was used before treatment and after cardioversion to measure the left ventricular ejection fraction(LVEF)and left ventricular end diastolic dimension(LVDD).Results The success rate of cardioversion of the observation group was 84.91%,not significantly different from that of the control group(88.68%,P>0.05).The cardioversion time of the observation group was(10.16±5.34)min,significantly shorter than that of the control group[(21.23±8.41)min,P<0.05].There were no significant differences in the levels of LVEF and LVDD before and after treatment,and average ventricular rate and QT interval before and after treatment between these 2 groups(all P>0.05).However,the LVEF after treatment of the observation group was significantly higher than that before treatment in the same grouo,and the LVDD after treatment of the observation group was significantly lower than that before treatment in the same group(both P<0.05).And the average ventricular rates after treatment of the 2 groups were both significantly lower than those before treatment(both P<0.05).Conclusion With rapid cardioversion and high safety,synchronous electrical cardioversion and amiodarone shows good clinical value in prehospital first aid for supraventricular tachycardia in young and middle-aged patients.

关 键 词：同步电复律 胺碘酮 中青年 室上性心动过速 院外急救 

分 类 号：R605[医药卫生—外科学]