心律失常的药物治疗—培训课件.ppt

* * * * * * * * * * 2000年国际指南/第六章/第五节： 一个随机比较胺碘酮和利多卡因的试验发现胺碘酮有更高的复苏成功可能性 Kentsch M, Berkel H, Bleifeld W. Intravenose Amiodarone - Applikation bei therapierefraktarem Kammerflimmen. Intesivmedizin. 1988; 25: 70 – 74 大量的动物试验和研究和回顾性、非对照性试验提示利多卡因降低了短期复苏成功率 van Walraven C, Stiell IG, Wells GA, Hebert PC, Vandemheen K, the OTAC Study Group. Do advanced cardiac life support drugs increase resuscitation rates from inhospital cardiac arrest? Ann Emerg Med. 1998; 32: 544 – 553 利多卡因和肾上腺素之间的一个随机对比研究显示应用利多卡因后有更高的心室停搏发生率，而在自主循环恢复方面无差别 Weaver WD. Fahrenbruch CE, Johnson DD, Hallstrom AP, Cobb LA, Copass MK. Effect of epinephrine and lidocaine therapy on outcome after cardiac arrest due to ventricular fibrillation. Circulation. 1990; 82: 2 027 - 2 034 一些研究观察到利多卡因治疗后除颤阈提高 Resuscitation from ventricular fiberllation : drug therapy. JAMA. 1968; 203: 255 – 260 The effect of lidocaine and bretylium on the difibrillation threshold during cardiac arrest and cardiopulmonary resuscitation. Proc Soc Exp Biol Med. 1986; 182: 63 – 67 Elevation of ventricular defibrillation threshod in dogs by antiarrhythmic drugs. Am Heart J. 1979; 98: 345 – 350 Evaluation of antiarrhythmic drugs on defibrillation energy requirements in dogs : sodium channel block and action potential prolongation. Circulation. 1989; 79: 1 106 - 1 117 Lidocaine causes a reversible, concentration - dependent increase in defibrillation energy requirements. J Am Coll Cardiol. 1986; 8: 327 – 332 Effect of lidocaine and brdtylium on energy requirements for transthoracic defibrillation: experimental studies. J Am Coll Cardiol. 1986; 7: 397 – 405 Bretylium tosylate versus lidocaine in experimental cardiac arrest[see comments]. Am J Emerg Med. 1990; 8: 492 – 495 Effects of amiordarone on refractory ventricular fibrillation in acute myocardial infarction : experimental study. J Am Coll Cardiol. 1994; 23: 253 - 258 * 2000年国际指南： 第一节 ACLS2000年导言：2000年国际指南大会关于ACLS建议的变化/复苏药理学： 利多卡因在8年前(1992年）已不再被推荐作为常规预防室性心律失常的药物用于AMI（ACLS2000） 第五节/心律失常及其