实用心电学杂志
實用心電學雜誌
실용심전학잡지
JOURNAL OF PRACTICAL ELECTROCARDIOLOGY JS
2015年
1期
54-57,61
,共5页
急性心肌梗死%心室电风暴%β受体阻滞剂
急性心肌梗死%心室電風暴%β受體阻滯劑
급성심기경사%심실전풍폭%β수체조체제
acute myocardial infarction%ventricular electrical storm%β-blockers
目的：通过对8例急性心肌梗死并发心室电风暴患者临床资料的分析，总结急性心肌梗死并发心室电风暴的临床特点及救治经验。方法分析总结8例患者性别、年龄、心肌梗死部位、心室电风暴发作距急性心肌梗死发病后时间、心室电风暴持续时间、治疗效果及预后等临床特点。结果8例患者中6例（75％）为男性，70～79岁4例（50％），6 h 以内发病5例（62．5％），下壁梗死5例（62．5％），心室电风暴平均持续时间（107．4±110．9）min，2例单用胺碘酮，3例胺碘酮加用硫酸镁，1例胺碘酮加利多卡因，2例胺碘酮治疗无效的患者使用艾司洛尔后心室电风暴立即终止。死亡2例，抢救成功6例，抢救成功率75％。结论心室电风暴好发于老年男性，常于急性心肌梗死后6 h 以内发病，右冠状动脉病变更易诱发心室电风暴，早期电复律、除颤及合理应用包括β受体阻滞剂在内的抗心律失常药物至关重要，抢救同时静脉溶栓开通罪犯血管是安全有效的。
目的：通過對8例急性心肌梗死併髮心室電風暴患者臨床資料的分析，總結急性心肌梗死併髮心室電風暴的臨床特點及救治經驗。方法分析總結8例患者性彆、年齡、心肌梗死部位、心室電風暴髮作距急性心肌梗死髮病後時間、心室電風暴持續時間、治療效果及預後等臨床特點。結果8例患者中6例（75％）為男性，70～79歲4例（50％），6 h 以內髮病5例（62．5％），下壁梗死5例（62．5％），心室電風暴平均持續時間（107．4±110．9）min，2例單用胺碘酮，3例胺碘酮加用硫痠鎂，1例胺碘酮加利多卡因，2例胺碘酮治療無效的患者使用艾司洛爾後心室電風暴立即終止。死亡2例，搶救成功6例，搶救成功率75％。結論心室電風暴好髮于老年男性，常于急性心肌梗死後6 h 以內髮病，右冠狀動脈病變更易誘髮心室電風暴，早期電複律、除顫及閤理應用包括β受體阻滯劑在內的抗心律失常藥物至關重要，搶救同時靜脈溶栓開通罪犯血管是安全有效的。
목적：통과대8례급성심기경사병발심실전풍폭환자림상자료적분석，총결급성심기경사병발심실전풍폭적림상특점급구치경험。방법분석총결8례환자성별、년령、심기경사부위、심실전풍폭발작거급성심기경사발병후시간、심실전풍폭지속시간、치료효과급예후등림상특점。결과8례환자중6례（75％）위남성，70～79세4례（50％），6 h 이내발병5례（62．5％），하벽경사5례（62．5％），심실전풍폭평균지속시간（107．4±110．9）min，2례단용알전동，3례알전동가용류산미，1례알전동가리다잡인，2례알전동치료무효적환자사용애사락이후심실전풍폭립즉종지。사망2례，창구성공6례，창구성공솔75％。결론심실전풍폭호발우노년남성，상우급성심기경사후6 h 이내발병，우관상동맥병변경역유발심실전풍폭，조기전복률、제전급합리응용포괄β수체조체제재내적항심률실상약물지관중요，창구동시정맥용전개통죄범혈관시안전유효적。
Objective By analyzing the clinical data of 8 cases with acute myocardial infarction (AMI)complicating ventricular electrical storm,to explore the clinical characteristics and treatment of the disease.Methods Various clinical features of the 8 patients such as sex,age,site of myocar-dial infarction,time interval between the onset of AMI and the attack of ventricular electrical storm, duration of ventricular electrical storm,efficacy and prognosis of treatment were all analyzed and sum-marized.Results Among the 8 patients,6 cases (75%)were males,and 4 cases(50%)were 70 -79 years old.Ventricular electrical storm attacked within 6 hours after AMI in 5 cases(62.5%).Infe-rior myocardial infarction occurred in 5 cases(62.5%).The average duration of ventricular electrical storm was (107.4 ±110.9)min.There were 2 cases treated by amiodarone alone,3 cases by amioda-rone plus magnesium sulfate,one case by amiodarone plus lidocaine,and when amiodarone therapy proved to be of no effect,esmolol immediately terminated ventricular electrical storm in 2 cases.Two cases died,and 6 cases were successfully rescued,with a survival rate of 75%.Conclusion Ven-tricular electrical storm are frequently diagnosed among elderly males,which usually attacks within 6 hours after AMI.Right coronary artery lesions are more likely to induce ventricular electrical storm. Early cardioversion,defibrillation and reasonable applications of antiarrhythmic drugs including β-blockers are extremely important.It proves to be safe and effective to give intravenous thrombolytic therapy and open criminal vessel during a rescue.
