作　　者： (徐宁）;

机构地区： 东台市人民医院急诊科

出　　处： 《中华卫生应急电子杂志》 2017年第3期160-162,共3页

摘　　要： 目的探讨阵发性室上性心动过速(PSVT)药物治疗的有效性和安全性。方法回顾性分析1998年8月至2016年6月我院急诊科急诊药物治疗的PSVT患者136例。观察生命体征(如血压、脉搏等)、心电图、心酶谱、肝肾功能等。结果 136例患者中维拉帕米复律成功率75%(78/104),普罗帕酮复律成功率88%(30/34),间羟胺复律成功16例,无死亡患者。3例70岁以上首次发作的PSVT患者复律成功后出现持续性心动过缓,确诊病态窦房结综合征(SSS)。结论药物复律目前仍是急诊科(尤基层医院)PSVT主要的复律选择,其中维拉帕米、普罗帕酮复律成功率均较高,三磷酸腺苷可作为无效病例的最终选择,但应做好复苏准备,谨慎使用。合并低血压,甚至血压测不出,使用间羟胺复律是有效的。对70岁以上首次发作的PSVT患者药物复律应谨慎。药物复律无效或有药物复律禁忌时则需具备条件行电复律复律。 Objective To investigate the efficacy and safety of emergency drug in the treatment of patients with paroxysmal supraventricular tachycardia( PSVT). Methods A retrospective analysis were made for 136 cases of PSVT patients treated in emergency department of our hospital from August 1998 to June 2016. Vital signs( such as blood pressure,pluse,etc),electrocardiogram,heart zymogram,liver and kidney function of these patients were analyzed. Results The successful rate of Verapamil in 136 cases was75%( 78/104). The successful rate of Propafenone was 88%( 30/34),and 16 cases were resuced successfully with Meta hydroxylamine. There were no death cases. However,3 cases of PSVT who were above 70 years of age were found to have persistent bradycardia after cardioversion,and the diagnosis of sick sinus syndrome( SSS) was confirmed. Conclusion Drug cardioversion for PSVT is still a main cardioversion way in emergency department( especially primary hospital), including Verapamil and Propafenone with higher sucessful rate. ATP can be used as the final choice for ineffective cases,but should be prepared for resuscitation and be used with caution. The hypotension,even blood pressure can't be measured,is effective in the use of Meta hydroxylamine. For PSVT patients over 70 years of age,drug cardioversion should be prudent. When the drug cardioversion is invalid or the drug is contraindicated,the direct cardioversion should be performed.

关 键 词： 心动过速 药物治疗 疗效