电复律、药物复律治疗急诊阵发性心房颤动患者的效果差异  

The difference between electrical cardioversion and drug cardioversion in the treatment of emergency patients with paroxysmal atrial fibrillation

作　　者：李飓[1] 项涛[1] LI Ju;XIANG Tao(Emergency Department,Chengdu Third People's Hospital,Chengdu Sichuan 610014,China)

机构地区：[1]成都市第三人民医院急诊科,四川成都610014

出　　处：《中国急救复苏与灾害医学杂志》2024年第6期725-729,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：2021年四川省医学青年创新科研课题项目(编号:Q21070)。

摘　　要：目的比较电复律、药物复律治疗急诊阵发性心房颤动患者的效果差异。方法选取2019年6月—2021年1月成都市第三人民医院收治的76例阵发性心房颤动患者,随机分为药物复律组与电复律组,采用卡方检验及t检验比较两组患者电复律与药理复律之间的疗效差异。结果将药物复律组与电复律组相比,分别33例(100.00%)和40例(93.00%)转化为窦性心律(绝对差异6.98%;95%CI:-0.82~0.98;P=0.25)。药物复律组从开始输注到转换的中位时间为24 min(IQR 21.00~82.00),但只有9例(27.00%)通过普鲁卡因胺转换。两组患者在14 d随访结果相似(P>0.05);无中风或死亡病例。结论相比于电复律,药理复律在治疗阵发性心房颤动患者向窦性心律转换的效果更为显著,值得临床推广使用。Objective To compare the effect of conversion to sinus rhythm in patients with paroxysmal atrial fibrillation in emergency department.Methods A total of 76 patients with PAF admitted from June 2019 to January 2021 were randomly divided into the pharmacological cardioversion group and the electrical cardioversion group.Chi-square test and t-test were used to compare the efficacy differences between electrical cardioversion and pharmacological cardioversion.Results Compared with the shock group,33 cases(100.00%)and 40 cases(93.00%)in the drug shock group were converted to sinus rhythm(absolute difference 6.98%;95%CI:from-0.82 to 0.98;P=0.25).The median time from infusion to conversion in the drug shock group was 24 min(IQR 21.00-82.00),but only 9 cases(27.00%)were converted by procainamide.The results at 14 days were similar between the two groups,with no strokes or deaths reported.Conclusion This study found that compared to electrical cardioversion,pharmacological cardioversion had a more significant effect in converting emergency patients with PAF to sinus rhythm.It is worth promoting the clinical use of pharmacological cardioversion.

关 键 词：急诊 心房颤动 电复律 药理学复律 

分 类 号：R541.75[医药卫生—心血管疾病]