院前急救中胺碘酮治疗快速心房纤颤的疗效分析.docVIP

院前急救中胺碘酮治疗快速心房纤颤的疗效分析 　　摘 要 目的：比较胺碘酮和毛花甙C（西地兰）静脉用药治疗院前急救中快速心房纤颤的疗效。方法：随机抽取2010年1月-2011年1月上海市医疗急救中心随车急救中用毛花甙C治疗心房纤颤的110例病例为Ⅰ组；2011年2月-2013年2月用胺碘酮治疗心房纤颤的110例病例为Ⅱ组。Ⅰ组静脉注射毛花甙C 0.4～0.8 mg。Ⅱ组静脉注射胺碘酮150 mg， 如未转复为窦性心律者， 重复给予75～150 mg，后改为静脉滴注150～450 mg。结果：胺碘酮组治疗效果优于毛花甙C 组，两组差异有统计学意义。结论：静脉注射胺碘酮治疗心房纤颤的作用迅速、安全， 其疗效优于毛花甙C。 　　关键词 院前急救 胺碘酮 毛花甙C 心房纤颤 　　中图分类号：R972.2； R541.75 文献标识码：A 文章编号：1006-1533（2014）11-0022-03 　　Analysis of the efficacy of amiodarone for the treatment 　　of rapid atrial fibrillation in pre-hospital emergency care 　　WEI Peizhen 1， TIAN Caijun 2 　　（1.Shanghai Medical Emergency Center， Shanghai 200438， China； 2. Shanghai Jiangong Hospital， Shanghai 200083，China） 　　ABSTRACT Objective： To compare the efficacy of amiodarone and lanatoside C（cedilanid） in the intravenous treatment of rapid atrial fibrillation at the pre-hospital emergency center. Methods： One hundred and ten cases of patients with atrial fibrillation treated with lanatoside C were randomly selected as group I in Shanghai Medical Emergency Center ambulance during Jan. 2010 - Jan. 2011 while another 110 cases treated with amiodarone as group II during Feb. 2011 - Feb. 2013. 0.4～0.8 mg of lanatoside C was intravenously given in group I and 150 mg of amiodarone in group II， and 75～150 mg of amiodarone were repeatedly given and then 150～450 mg of amiodarone if the patients did not convert to sinus rhythm. Results： The efficacy of amiodarone was better than that of lanatoside C， and the difference was statistically significant. Conclusion： Amiodarone in the treatment of atrial fibrillation possesses quick action and good safety and its efficacy is much better than lanatoside C. So it is recommended as the first choice for the treatment of fast atrial fibrillation in pre-hospital emergency. 　　KEY WORDS pre-hospital emergency； amiodarone； lanatoside C； atrial fibrillation 　　快速心房纤颤是近年来心血管疾病中常见的一种快速心律失常，也是院前急救中最常见的。随着城市人口老龄化的发展和心血管疾病发病率的不断上升，心房纤颤患者的数量也在悄然增加[1]。对快速心房纤颤的心室率进行迅速有效地控制在维持血液动力学稳定、改善左室功能、减少