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目的:观察胺碘酮治疗老年人急性心肌梗死合并快速心室率心房颤动的安全性及疗效。方法:选取48例近1个月内发生心肌梗死,入院后24h内并发的心室率>120次/min快速心室率心房颤动的老年患者,年龄65~85岁,给予胺碘酮静脉加口服治疗,观察心房颤动转复及维持情况、心室率控制情况、血压变化情况、30d病死率及不良反应。结果:48例患者中41例(85.4%)在48h内恢复窦性心律,3例死亡,4例未转复。转复与未转复的45例患者用药后心室率明显下降(P<0.01),用药前后血压无明显变化(P>0.05)。1例出现窦性心动过缓,3例出现长R-R间歇,1例血压出现下降,2例患者出现静脉炎。45例患者经电话随访30d内无一人死亡,无其他不良反应。结论:老年人急性心肌梗死合并快速心室率心房颤动时,静脉滴注加口服应用胺碘酮是有效及安全的。
Objective: To observe the safety and efficacy of amiodarone in the treatment of elderly patients with acute myocardial infarction complicated with rapid ventricular rate atrial fibrillation. Methods: Forty-eight elderly patients with myocardial infarction within one month and ventricular rate> 120 beats / min with ventricular rate within 24 hours after admission were enrolled in this study. Patients aged 65-85 years were treated with intravenous amiodarone and oral , Observed the recovery and maintenance of atrial fibrillation, ventricular rate control, blood pressure changes, 30d mortality and adverse reactions. Results: In 48 patients, 41 cases (85.4%) recovered sinus rhythm within 48 hours, 3 died and 4 cases did not recover. The ventricular rate was significantly decreased in 45 patients with and without reversion (P <0.01), with no significant changes in blood pressure before and after treatment (P> 0.05). One patient had sinus bradycardia, three patients had long R-R intermittent, one patient had a decrease in blood pressure and two patients had phlebitis. None of the 45 patients died within 30 days of telephone follow-up and had no other adverse reactions. Conclusion: Intravenous drip and oral administration of amiodarone are effective and safe for elderly patients with acute myocardial infarction complicated by rapid ventricular rate atrial fibrillation.