陣發(fā)性室上性心動(dòng)過速急診治療臨床分析

[摘要] 目的 分析陣發(fā)性室上性心動(dòng)過速（ paroxysmal Paroxysmal ventricular tachycardia，PSVT）急診治療效果，總結(jié)治療經(jīng)驗(yàn)。方法 方便選取2013年2月—2016年5月該醫(yī)院門急診收治的陣發(fā)性室上性心動(dòng)過速患者作為實(shí)驗(yàn)對(duì)象，入選114例，據(jù)病例號(hào)，隨機(jī)對(duì)照分組，A組、B組各57例，分別采用胺碘酮、普羅帕酮治療，對(duì)比療效、不良反應(yīng)。結(jié)果 A組、B組總有效率分別為94.74%、84.21%，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）；A 組復(fù)律時(shí)間（18.3±10.2）min，高于B組（15.3±6.3）min，A組30 min心率下降（97.3±17.2）次/min高于B組（83.5±20.8）次/min，A組不良反應(yīng)發(fā)生率5.26%低于B組22.81%，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 陣發(fā)性室上性心動(dòng)過速急診治療療效較好，多數(shù)患者可快速?gòu)?fù)律，易搏定、可達(dá)龍療效均較好，前者不良反應(yīng)發(fā)生率更低。

[關(guān)鍵詞] 陣發(fā)性室上性心動(dòng)過速；急診；胺碘酮

[中圖分類號(hào)] R541.7 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-0742（2016）11（c）-0101-03

[Abstract] Objective To analysis paroxysmal supraventricular tachycardia speed paroxysmal ventricular tachycardia （paroxysmal paroxysmal ventricular cases， paroxysmal supraventricular tachycardia （PSVT） the effectiveness of emergency treatment， summarize the experience of treatment. Methods Convenient selection from February 2013 to May 2016， hospital outpatient and emergency department of our hospital patients with paroxysmal supraventricular tachycardia were as the experimental object， selected object in 114 cases， according to the number of cases were randomly divided into two groups， group A， group B of the selected object 57 cases were treated with amiodarone and verapamil hydrochloride treatment， compared the efficacy and adverse reactions. Results The total efficiency of group A and group B were 94.74% and 84.21%， the difference was not statistically significant （P > 0.05） ；Group a complex time law （18.3±10.2） min， higher than group B （15.3±6.3） min， heart rate for 30 min in group a decreased（97.3±17.2） times / min is higher than that of group B （83.5±20.8） times/min ， the adverse reactions of group a occurred was 5.26% lower than that of group B 22.81%， the difference has statistical significance（P < 0.05）. Conclusion Paroxysmal supraventricular tachycardia Speed emergency treatment efficacy is good， the majority of patients can fast recovery， easy to beat， up to long curative effect is better， but the incidence of adverse reaction is low.

[Key words] Paroxysmal ventricular tachycardia； Emergency； Amiodarone

陣發(fā)性室上性心動(dòng)過速是臨床常見病，發(fā)病率約為0.25%，病因較復(fù)雜，患者多無既往病史，多因疲勞等原因誘發(fā)入院，患者承受較大的心理壓力。陣發(fā)性室上性心動(dòng)過速患者以心悸、胸悶、呼吸困難等為主要癥狀，急診入院者甚至可出現(xiàn)心絞痛，極少部分并發(fā)休克，若診治不及時(shí)可致死亡[1]。急診治療陣發(fā)性室上性心動(dòng)過速以用藥為主要治療手段，以控制癥狀，減輕心肌損傷為主要目的，避免心功能惡化，為消融手術(shù)創(chuàng)造條件。目前，可用于治療陣發(fā)性室上性心動(dòng)過速藥物主要包括胺碘酮、普羅帕酮，關(guān)于兩種藥物療效與安全性仍存在爭(zhēng)議。該次研究試以2013年2月—2016年5月該醫(yī)院門急診收治的陣發(fā)性室上性心動(dòng)過速患者114例作為研究對(duì)象，對(duì)比兩種藥物療效，現(xiàn)報(bào)道如下。……