中国血液净化

›› 2004, Vol. 3 ›› Issue (4): 198-200.

• 论著 • 上一篇    下一篇

静脉用胺碘酮治疗血液透析并发严重快速性心律失常的临床疗效分析

韦 锋   

  1. 529000 江门，广东省江门市中心医院内二科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-04-12 发布日期:2004-04-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-04-12 Published:2004-04-12

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摘要： 目的 观察静脉使用胺碘酮对血液透析并发快速性心律失常的疗效。方法 15例急、慢性肾衰 竭重症患者，男性6例，女性9例，年龄(55.0±21.5)岁，于透析中共出现快速性心律失常22例次，给予胺碘酮50～100mg缓慢静脉注射，然后100～150mg持续静脉滴注(8～24ug/kg/min)，必要时重复；观察症状、心率、心律、QT间期变化，并与15例非透析对照患者比较疗效。结果 13例次（59.1%）15分钟内复律及心室率降到100次/分以下；6例次（27.3%）15～30分钟复律或心室律降到100次/分以下；3例次（13.6%）30分钟后心室率未转为窦性或心室率未降至100次/分以下，但心室率亦明显下降至120～130次/分，于补钾后以西地兰0.2mg静脉滴注复律。治疗后症状明显改善，QT间期无显著性差异 (P>0.05)。1例出现窦性心动过缓，停用胺碘酮后恢复正常。疗效与对照组比较无显著性差异(P>0.05)。结论 静脉注射胺碘酮对重症尿毒症患者透析中出现的快速性心律失常疗效显著、安全。

关键词: 胺碘酮, 尿毒症, 血液透析, 快速性心律失常

Abstract:

Objective To investigate the effect of intravenous amiodarone on treating tachyarrythmia happened during hemodialysis. Methods Fifteen severe acute and chronic renal failure patients, including 6 male and 9 female, whose age averaged (55±21.5) years, occured tachyarrhythmia 22 times during hemodialysis. They were given introvenous amoiodarone for 50～100mg showly, then continuous intravenous drip for 100～150mg at the dose of 8～24μg/kg/min and repeated if necessary. The patients' symptoms, heartrate, cardiac rhythm and QT interphase were obserred and compared with 15 nondialysis controls. Results Thirteen times (59.1%) of the 22 tachy arrhythmia recovered sinus rhythm and the heart rates decreased to less than 100 pulse/min in 15 minutes, 6 times (27.3%) in 15～30 minutes and 3 times (13.6%) could not recover sinus rhythm in 30 minutes, but their heart rates decreased to 120～130 pulse/min and recovered sinus rhythm after supplementing potassium and intravenous injection of 0.2mg cedilanid. Patients' symptoms relieved quickly. There was no significont difference of QT interphase after therapy (P>0.05). One patient occured bradycardia and recovered after stopping amiodarone. There was no significant difference of therapy effect compared with the controls(P>0.05). Conclusions intravenous amiodarone is an effective and safe management of the serious tachyarry-thmia caused by hemodialysis.

Key words: Uremia, Hemodialysis, Tachyarrhythmia

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