静注胺腆酮治疗急性心肌梗塞后恶性心律失常观察(回修稿).docVIP

胺碘酮治疗急性心肌梗塞后恶性心律失常的临床观察 莫 逆 陈海坚 梁金春 广东省高州市人民医院心内科 525200 【摘要】 目的 探讨静脉滴注胺碘酮治疗急性心肌梗死并发恶性心律失常患者的临床疗效及安全性。方法 30例急性心肌梗死后伴发恶性心律失常患者，先静注胺碘酮负荷量治疗，继以0.5~1mg/min维持，观察心律转复、血压变化及副作用情况。结果 30例患者中显效20例，有效8例，无效2例，用药后血压明显回升，心室率显著下降（P﹤0.05）。2例患者用药后出现心动过缓，药物减量后恢复正常。结论 静注胺碘酮治疗急性心肌梗死并发恶性心律失常是一种安全有效方法。 【关键词】 胺碘酮；心肌梗死；急性；心律失常 Clinical observation of intravenous amiodarone in the treatment of HYPERLINK /search?q=seriouskeyfrom=E2Ctranslationserious fibrillation in patients with acute myocardial infarction MO Yi,CHEN Haijian,LIANG Jinchun,et al.Department of Cardiology , GAO-ZHOU PEOPLE Hospital 【abstract】 Objective To explore the clinical effectiveness and safety of intravenous amiodarone in the treatment of acute myocardial infarction (AMI)patients with malignant arrhythmia.Methods 30 AMI with malignant arrhythmia patients, After an intravenous load, amiodarone was intravenously infected continuously 0.5~1mg/min, Efficacy of amiodarone in the reversion rhythm of the heart, blood pressure changes as well as the side effects were observed.Results Among the?30?patients, excellence 20, effective 8 , invalid 2, and blood pressure obvious picks up, ventricular rate decreased obviously after medication (P﹤0.05). Bradycardia was observed in 2 patients, patients’ cardiac rhythm return to normal state after reducing the dose administration of the drug. Conclusion Intravenous amiodarone is effective and safe in the treatment of malignant arrhythmia in patients with AMI. 【Key words】Amiodarone；Myocardial infarction；Acute；HYPERLINK /search?q=arrhythmiakeyfrom=E2CtranslationArrhythmia 急性心肌梗死(acute myocardial infarction，AMI)时，由于缺血性心电不稳定、泵衰竭、过度交感兴奋等，可引起室性心动过速或心室颤动等各种恶性的心律失常，威胁患者的生命，对患者预后造成严重影响[1]，故需紧急处理。胺碘酮在治疗上述心律失常问题中的疗效和安全性已被肯定,但在临床实际工作中其用法和用量范围还有待于进一步探讨[2]。现将我科2009年2月～2011年1月30例静脉应用胺碘酮治疗AMI合并恶性心律失常的病例总结报告如下。 1.资料与方法 1.1 一般资料　2009年2月至2011年1月在我科收治的245例AMI患者中, 30例反复出现室性心动过速或心室颤动同时伴有严重血液动力学障碍的恶性心律失常，其中男18例，女12例，年龄42～78(51.3±6.5)岁。梗死部位:前壁14例，前壁并