CAJ | 학술논문

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±700.53) mg,转复时间(6.34±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.
목적 관찰대제량알전동지속정맥빙주전복진발성방전적유효성화안전성.방법 2008-2010년3년간료양석화총의원수치적진발성방전환자109례,응용대제량알전동(125mg/h)지속정맥빙주전률치료.전률전균급여저분자간소항응치료,화험FT3、FT4、TSH、혈청리자등,주심장채초,행심전、혈압감호;응용염산알전동주사제(가체룡)150mg가입0.9％적록화납50 mL중혼균,이41 mL/h속도지속빙주,즉알전동125mg/h,직지전복위두성심률혹체24h;전복후시정황개용0.5～1 mg/min유지6～12 h병가용알전동구복,24h내정맥용알전동총량불초과3000 mg.결과 104례전위두성심률,성공솔위95.41％,알전동적전복제량위(774.52±700.53) mg,전복시간(6.34±5.55)h.결론 진발성방전환자응용대제량알전동(125 mg/h)지속정맥빙주전률치료구유전복성공솔고、병발증화불량반응소등우점,재기층의원유엄활적응용전경.
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 ± 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.