靜脈泵注大劑量胺碘酮轉(zhuǎn)復(fù)陣發(fā)性房顫109例療效研究

1、靜脈泵注大劑量胺碘酮轉(zhuǎn)復(fù)陣發(fā)性房顫109例療效研究d0i： 10. 3760/cma. j. issn. 1671-0282.2014.04. 017作者單位：111003遼寧省遼陽，遼陽石化總醫(yī)院內(nèi)科 通信作者：成娟，email： lhyycheng163. com【摘要】目的觀察大劑量胺碘酮持續(xù)靜脈泵注轉(zhuǎn)復(fù)陣 發(fā)性房顫的有效性和安全性。方法2008-2010年3年間遼陽 石化總醫(yī)院收治的陣發(fā)性房顫患者109例，應(yīng)用大劑量胺碘 酮（125 mg/h）持續(xù)靜脈泵注轉(zhuǎn)律治療。轉(zhuǎn)律前均給予低分 子肝素抗凝治療，化驗ft3、ft4、tsh、血清離子等，做心 臟彩超，行心電、血壓監(jiān)護(hù)；應(yīng)用鹽酸胺碘酮注

2、射劑（可達(dá) 龍）150 mg加入0.9%的氯化鈉50 ml中混勻，以41 ml/h 速度持續(xù)泵注，即胺碘酮125 mg/h ,直至轉(zhuǎn)復(fù)為竇性心律 或達(dá)24 h；轉(zhuǎn)復(fù)后視情況改用0. 51 mg/min維持612 h 并加用胺碘酮口服，24 h內(nèi)靜脈用胺碘酮總量不超過3000 mgo結(jié)果104例轉(zhuǎn)為竇性心律，成功率為95.41%,胺碘酮 的轉(zhuǎn)復(fù)劑量為（774. 52±700. 53）mg,轉(zhuǎn)復(fù)時間（6. 34±5. 55） ho結(jié)論陣發(fā)性房顫患者應(yīng)用大劑量胺碘酮（125 mg/h）持 續(xù)靜脈泵注轉(zhuǎn)律治療具有轉(zhuǎn)復(fù)成功率高、并發(fā)癥和不良反應(yīng) 少等優(yōu)點，在基層醫(yī)院有廣闊的應(yīng)用前景。

3、【關(guān)鍵詞】胺碘酮；大劑量；持續(xù)靜脈泵注；陣發(fā)性房顫；轉(zhuǎn)律analysis of the effects of high-dose amiodarone on cardioversion of paroxysmal atrial fibrillation in 109 patients cheng juan, wang hong, liu min, pang yanyou, shen ningyang, ji jing, wang fujie department of internal medicine , liaoyang petrochemical general hospital, li

4、ao yang 111003 , chinacorrespondingauthor :cheng juan , email :lhyycheng163. comabstract objective to observe the efficacy and safety of high-dose amiodarone administered by continuously intravenous infusion for cardioversion of paroxysmal atrial fibrillation. methodsfrom 2008 to 2010,109 patients s

5、uffered from paroxysmal atrialfibrillation were treated with high-dose amiodarone (125 mg/h) administered by continuously intravenous infusion. before cardioversion, patients were treated with low molecular weight heparin anticoagulant therapy, laboratory tests on ft3, ft4, tsh, serum ions, etc, and

6、 coloured doppler ultrasound imaging of heart, and ecg and blood pressure monitoring were carried out. amiodarone hydrochloride injectio of 150mg was mixed with sodium chloride 50 ml homogeneously, and then infused continuously by micro-pump in a rate of 41 ml/h until resume of sinus rhythm or infus

7、ion was kept up to 24 h.after successful cardioversion, as appropriate , the intravenous amiodarone was maintained in a rate of 0. 5一1 0 mg/min for 6-12 h joined with oral amiodarone dosing, and the total dose was limited up to 3000 mg. resultsa cohort of 104(95. 4%)patients had the restoration of s

8、inus rhythm after cardioversion. the mean dose of amiodarone for cardioversion was ( 774. 52 + 700. 53 ) mg, and time required for cardioversion was ( 6. 3 + 5. 55 ) hours conclusionsthe patients with paroxysmal atrial fibrillation are given high-dose amiodarone (125 mg/h) continuously intravenous infusion therapy and have high cardioversion success rate, less comp