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扭转型室速(Tdp)不但有其特殊的心电图表现,且需要独特的治疗,除消除诱因外,常采用心脏起搏、异丙肾上腺素和硫酸镁。最近报告 Tdp 的发生机制可能与触发活动有关,故认为钙拮抗剂有效,但其效果尚未进行充分研究。为此,作者采用60只杂种成犬,在静脉麻醉、人工呼吸下在第5肋间开胸,切开心包,进行心外膜标测和电生理程序刺激,测定了心室的有效不应期(ERP)和 ERP 不均一性指标(△ERP),即最大 ERP 减最小 ERP。在控制状态下给心室刺激不能诱发室速后,静注硫酸奎尼丁30mg/kg,10分钟,用电刺激心室诱发 Tdp。诱发的 Tdp 自然停止或电转复后,9只静滴异丙肾上腺素(0.5μg/kg/分钟),8只静注硫酸镁(30mg/kg/5分钟),10只静注异搏停(0.1mg/kg)后,连续静滴
Tdp not only has its own special electrocardiogram, and requires a unique treatment, in addition to eliminating incentives, often using cardiac pacing, isoproterenol and magnesium sulfate. Recent reports that the mechanism of Tdp may be triggered activity, it is considered that calcium antagonists effective, but its effect has not been fully studied. To this end, the author used 60 hybrids adult dogs under anesthesia, artificial respiration in the 5th intercostal thoracotomy, incision pericardium, epicardial mapping and electrophysiological stimulation program, the determination of ventricular effective refractory period (ERP) and ERP heterogeneity index (△ ERP), that is, the maximum ERP minus the minimum ERP. In the control state to the ventricular stimulation can not induce ventricular tachycardia, intravenous quinidine sulfate 30mg / kg, 10 minutes, the electrical stimulation of ventricular Tdp. Nine induced intravenous isoproterenol (0.5 μg / kg / min), 8 intravenous magnesium sulfate (30 mg / kg / 5 min) and 10 intravenous 0.1mg / kg), continuous intravenous infusion