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目的回顾胺碘酮静脉应用治疗急性心肌梗死(AMI)患者并发快速心律失常的临床疗效及安全性分析。方法急性心肌梗死患者急性期出现心律失常时应用胺碘酮静脉注射,减少或者终止快速心律失常的发生。结果 36例患者中2例收缩压由16.5 kpa、17.2 kpa降至13.5 kpa,1例心率由89次/min降至50次/min,1例出现短阵房室传导延迟,经停药后恢复正常。2例室性心动过速应用胺碘酮2次,间隔15 min,未转复窦性心律,血压下降至80/50 mm Hg(1 mm Hg=0.133 k Pa)及75/40 mm Hg,均给予100 J直流电复律一次后转为窦性心律。2例在静脉注射胺碘酮中出现恶心呕吐,停药后消失,2例出现血压下降,应用多巴胺静脉滴注维持血压,当转为窦性心律时血压恢复正常,停用多巴胺。其他患者未出现异常反应。结论胺碘酮能有效的终止快速心律失常,减少恶性事件的发生。
Objective To review the clinical efficacy and safety of intravenous amiodarone in the treatment of patients with acute myocardial infarction (AMI) complicated with tachyarrhythmia. Methods Acute myocardial infarction patients with acute arrhythmia intravenous amiodarone to reduce or terminate the occurrence of tachyarrhythmia. Results The systolic blood pressure decreased from 16.5 kPa and 17.2 kpa to 13.5 kpa in 2 of 36 patients. The heart rate of one patient decreased from 89 beats / min to 50 beats / min. One patient had a short atrioventricular conduction delay and recovered after stopping normal. 2 cases of ventricular tachyarrhythmia were treated with amiodarone 2 times with 15 min interval without sinus rhythm. The blood pressure dropped to 80/50 mm Hg (1 mm Hg = 0.133 k Pa) and 75/40 mm Hg Give 100 J DC cardioversion once converted to sinus rhythm. 2 cases of nausea and vomiting in intravenous amiodarone disappeared after stopping, 2 cases of blood pressure drop, the use of dopamine intravenous maintenance of blood pressure, when converted to sinus rhythm blood pressure returned to normal, the withdrawal of dopamine. No abnormal reaction in other patients. Conclusion Amiodarone can effectively terminate the tachyarrhythmia and reduce the incidence of malignant events.