胺碘酮静脉注射治疗快速性心律失常20例临床观察

目的 探讨胺碘酮静脉给药治疗快速性心律失常的疗效及安全性。方法 20例难复性快速心律失常患者，予胺碘酮静脉注射液150mg溶于5％葡萄糖液20ml 15min内缓慢静脉注射，无效的间隔15min后重复1次，再以0．5—1mg／min维持静脉滴注，12例病人同时口服胺碘酮。结果 20例快速心律失常均被有效控制。结论 胺碘酮有较强的抗心律失常作用。它对房性、房室交界性、室性及预激综合征伴发的心律失常均有很好的疗效。     

胺碘酮治疗快速性心律失常63例临床疗效观察

目的了解胺碘酮治疗快速性心律失常的临床疗效和安全性。方法对63例快速性心律失常患者给予胺碘酮150mg稀释后静脉注射,30min可视心律情况追加150mg,最多可静脉注射3次,随后以0.5～2.0mg/min维持静脉滴注2～10d,续以胺碘酮0.2mg,1日3次口服。结果总有效率98%,治疗期间3例出现心动过缓,6例出现低血压,经对症治疗后上述症状均缓解。治疗前后患者血压、心率及心电图间差异有统计学意义（P〈0.05）。结论胺碘酮治疗快速性心律失常疗效明显,未见明显不良反应。     

胺碘酮在心律失常治疗中的应用现状

大量临床研究发现胺碘酮在治疗和预防心律失常(如心房颤动、心房扑动、室性心动过速、心室颤动等)上疗效肯定,因此正确认识和评价胺碘酮对心律失常治疗的研究有重要意义.现就胺碘酮的作用机理、应用现状和不良反应作简要综述.     

胺碘酮治疗心律失常53例临床分析

2004年1月~2006年1月,我院应用胺碘酮治疗心律失常53例,获得满意疗效。现报告如下。临床资料:本组53例患者中,男39例,女14例;年龄31~81岁,平均59.5岁。均曾应用多种抗心律失常药物(如异搏定、慢心律、心律平、心得安及普鲁卡因酰胺)治疗,疗效不佳。其中频发性早搏16例,频发性早     

胺碘酮静脉治疗危重患者并快速房性心律失常30例分析

目的评价胺碘酮静脉治疗临床各科危重患者并发快速房性心律失常的疗效与安全性。方法对来自各科的30例危重症患者，给予胺碘酮5mg／kg负荷剂量静脉注射，如无效，则将胺碘酮加入输液泵中以1mg/min静脉持续治疗6小时。结果30例危重患者中有26例心律失常被及时有效终止，有效率为86．7％。无一例患者发生严重的不良反应。结论胺碘酮静脉治疗临床疗效显著，安全性高，可作为临床各科危重患者并发快速房性心律失常的首选用药。     

静脉应用胺碘酮治疗不同类型阵发性心动过速35例报告

快速性心律失常临床上较为常见 ,有时病情紧急 ,甚至威胁生命 ,需立即处理。我们采用胺碘酮静脉用药治疗不同类型心动过速 ,效果满意 ,现报告如下。1　资料与方法1 .1　临床资料　本组男 2 7例、女 8例 ,年龄2 1～ 80岁、平均 48.5± 1 3.2岁 ;其中冠心病1 0例 ,肺心病 2例 ,风湿性心脏病 5例 ,致心律失常性右室发育不良 2例 ,高血压病 2例 ,无明显器质性心脏病 1 4例。心动过速类型为房性心动过速 3例 ,显性预激综合征 1 0例 (其中合并房室折返性心动过速 7例 ,房性颤动 3例 ) ,隐匿性预激综合征 1 1例 ,阵发性房性颤动 (室性心率超过 1 0 …     

胺碘酮联合中药治疗心律失常108例

胺碘酮联合中药治疗心律失常１０８例寿光市人民医院（２６２７００）寿光化工总厂职工医院张庆祥王瑞云徐西林张松村李友芳我们采用胺碘酮联合中药治疗心律失常１０８例，效果较好。患者年龄３８～７７岁，均经心电图检查证实，６８例做２４小时动态心电图检查，均曾用多...     

静脉胺碘酮的主要不良反应分析

目的了解静脉胺碘酮在实际应用中出现的主要不良反应情况，探讨如何进一步规范使用胺碘酮，减少其副作用。方法对本院在2003年10月到2005年9月的静脉使用胺碘酮的全部住院病历进行回顾性研究，对出现不良反应的病例进行统计与分析。结果静脉胺碘酮后出现肝功能异常的发生率为12．6％，男性比女性更容易发生肝功能异常。重度肝功能异常的病例9例，需干预的严重心动过缓7例，需干预的低血压4例，过敏反应1例。结论尽管静脉胺碘酮有可能导致一些副作用，但只要密切监测，早期发现，早期处理，其使用是安全有效的。     

静脉大剂量胺碘酮转复高龄患者术后快速心房颤动二例

例 1　男性 ,78岁。因上腹隐痛 2月、胃镜活检诊断为早期胃癌入院。既往有高血压病 2级、高血压性心脏病、Ⅱ型糖尿病、慢性萎缩性胃炎等病史 ,长期服用降压及降糖药物 ,血压、空腹血糖和餐后 2ｈ血糖维持在正常范围。动态心电图示 :窦律 ,房性早搏 (简称房早 ) 2 4ｈ 374次 ,短阵心房颤动 (简称房颤 ) ,心室率 12 0～ 140次 /分。胸片 :左室大 ,心胸比例 >0 .5。超声心动图 :左房 45ｍｍ ,左室舒张末期和收缩末期内径分别为 5 8和 49ｍｍ ,室间隔及左室后壁厚度均为 12ｍｍ ,左室顺应性下降。入院后行胃大部切除 (毕氏Ⅱ型 ) ,术后第 2日突…     

胺碘酮静脉用药并口服治疗顽固性心律失常观察

目的:观察胺碘酮静脉用药并口服对顽固室性心律失常的疗效。方法:回颐性分析42例顽固性室性心律失常患者静脉用药并口服胺碘酮治疗的资料。结果:88．1％患者心律失常得以控制,用药前、后P-R间期、QRS波、血压变化无统计学意义。结论:静脉并口服胺碘酮治疗顽固室性心律失常安全,有效。     

Effect of intravenous amiodarone in patients with intraventricular conduction disorders

Using His bundle recordings and stimulation techniques, theelectrical effects of amiodarone (5 mg/kg intravenously) wereassessed in 12 patients aged 34–80 years (mean 65) exhibitingin sinus rhythm, intraventricular conduction disturbances. Bundlebranch block was present in 10 patients: left bundle branchblock in three patients, right bundle branch block in three,bilateral bundle branch block in four. All the patients hada long H-V interval (65–80 ms; mean 71). As has been previouslyreported, amiodarone slowed the sinus rate, prolonged the QTinterval, increased the atrial effective refractory period anddepressed A-V nodal conduction. Despite the presence of advancedconduction disturbances within the His-Purkinje system, amiodaronedid not alter the H-V interval in 11 patients and increasedit in one by only 5 ms. Thus, clinically, the use of amiodaronein patients with bundle branch block should be safe.     

Hemodynamic effects of intravenous amiodarone

Amiodarone is a potent antiarrhythmic agent that is effective in controlling both atrial and ventricular arrhythmias. Recently, intravenous administration was demonstrated to be effective in the acute management of rhythm disorders and, in addition, appeared to shorten the loading period normally required for oral drug administration. This investigation examined the hemodynamic effects of amiodarone after both acute intravenous bolus and continuous intravenous administration. Patients with a left ventricular ejection fraction greater than 0.35 experienced improved cardiac performance due to both acute and chronic peripheral vasodilation. However, patients with a lower ejection fraction developed a 20% decrease in cardiac index and clinically significant elevation of right heart pressures after acute bolus administration; these changes were variably compensated for by peripheral vasodilation when the drug was administered intravenously over 3 to 5 days continuously. Therefore, intravenous amiodarone can result in significant impairment of left ventricular performance in patients with preexisting left ventricular dysfunction.     

静脉用胺碘酮和毛花甙C转复阵发性房颤即时疗效对比

目的:比较静脉用胺碘酮和毛花甙C治疗阵发性房颤(PAF)的即时疗效和安全性。方法:84例发作时间在 24～72 h的PAF患者被随机分为胺碘酮组和毛花甙C组(每组42例),分别静脉内给予胺碘酮150～1180 mg和毛花甙C 0．4～0．8 mg。结果:胺碘酮和毛花甙C PAF转复率分别是83．3％和42．9％(P<0．01);未转复者的心室率在胺碘酮组由(128．4±12．3)降至(87．8±11．4)次／min(P<0．01),毛花甙C组由(129．6±13．1)降至(90．3± 11．9)次／min(P<0．01)。两组均无严重副作用发生。结论:静脉用胺碘酮治疗阵发性房颤有效且安全,其转复率显著高于毛花甙C。     

Use of intravenous amiodarone for emergency treatment of life-threatening ventricular arrhythmias

Efficacy, side effects and predictors of response for intravenous amiodarone were evaluated in 46 patients with recurrent drug-refractory sustained ventricular tachycardia or ventricular fibrillation, or both, who were treated with intravenous amiodarone. Of the 46 patients, 27 (58.5%) responded early to intravenous amiodarone and 6 (13%) showed a late response to amiodarone. The majority of patients who responded to intravenous amiodarone did so within the first 2 h of therapy, and all responded within 84 h. Patients with an ejection fraction greater than 25% were more likely to respond (p less than 0.05). Major side effects occurred in 13% of patients. The cumulative 2 year mortality rate due to arrhythmia recurrence or sudden death for responders discharged from the hospital was 23% and the cumulative overall 2 year mortality rate was 46%. In conclusion, intravenous amiodarone is rapidly effective in the majority of patients with recurrent ventricular tachycardia or ventricular fibrillation refractory to other drugs. The poor long-term outcome of patients who require this therapy, respond to it and are discharged on long-term oral amiodarone therapy warrants consideration of other long-term treatment of these patients. Use of intravenous amiodarone is an important new modality in the treatment of drug-refractory malignant ventricular arrhythmias.     

458例内科住院病人营养状况调查

目的调查内科住院病人营养状况,营养不良与科别、年龄的相关性,为住院病人合理应用营养支持治疗提供参考依据。方法选择本院消化内科、呼吸内科、神经内科、内分泌科、心内科、肾内科新住院病人458例,进行人体测量和生化指标检测,包括身高、体质量、血清白蛋白（ALB）、总淋巴细胞计数（TLC）、人体质量指数（BMI）、血红蛋白（HB）等,统计营养不良的发生率。结果内科患者入院时低质量率为6．8％,超重发生率为33．2％,肥胖发生率为12．7％,低蛋白血症发生率为8．4％,贫血发生率为16．1％,总淋巴细胞计数减少发生率为64．7％。科室间营养不良发生率存在显著性差异。结论内科住院患者入院时已有较高的营养不良发生率,因科别、年龄不同,营养不良发生率和特点亦不同,总淋巴细胞计数是评价营养状况的敏感指标之一。     

Nutritional status of patients hospitalized in pediatric clinic.

BACKGROUND/AIMS: The aim of this study was to evaluate the nutritional status of children at the moment of their hospitalization and to investigate whether there is a relation between the diagnosis and nutritional status. METHODS: Patients hospitalized in the Children's Clinic of Cerrahpasa Medical Faculty (excluding emergency, newborn intensive care and newborn special care units) between December 2003 and August 2004 were included in the study. All patients' height, weight, weight for height head circumference, arm circumference, triceps skin-fold thickness, and Z results of the height and weight were measured and, in accordance with the anthropometric measurements at the moment of hospitalization, each patient's nutritional status was evaluated. The average of the values was compared to diagnosis. RESULTS: 223 (42.2%) of a total of 528 patients were female. Patients' ages varied from one month to 23 years (5.8+/-5.3). The evaluated average height and weight Z scores of the patients were -0.6+/-1.9 and -0.7+/-1.5. Evaluation of height for age showed that in 27% of cases there was chronic malnutrition. Evaluation of weight for age and weight for height showed that in 52.4% and 40.9% of the cases, respectively, there was acute malnutrition. In 45.7% of the cases the body mass index was below -2 standard deviations. The evaluation of patients' diagnoses revealed 83 cases (15.7%) diagnosed as acute or chronic respiratory system disease. Malnutrition was most common among patients suffering from diseases from the following groups: chronic kidney insufficiency, genetic diseases, immune insufficiency and cystic fibrosis. CONCLUSION: Malnutrition among hospitalized children and especially those with chronic diseases is worth attention. Evaluation of the nutritional status and nutritional support are elements of the diagnostic and treatment process. In particular, closer observation and nutritional support are required in the cases of patients diagnosed with chronic kidney insufficiency, immune insufficiency, neurological diseases, and cystic fibrosis.     

静脉注射胺碘酮对冠心病快速型室上性心动过速的疗效

目的:观察静脉注射胺碘酮治疗冠心病快速型室上性心律失常(SVT)的疗效。方法:入选冠心脏病合并SVT患者,心动过速发作1～6h 79例,随机分为胺碘酮组(41例,脉注射胺碘酮150～450mg或改为静脉恒速泵注入),毛花甙C组(38例,静脉注射毛花甙C 0.4～1.0mg),观察其心率、QT间期变化及药物副作用。结果:两组心率均有明显控制,肢碘酮和毛花甙C组对STCA的有效率分别为92.6％与73.6％,胶碘酮疗效高于毛花甙C(P<0.01),QT间期及副作用差异无显著性意义。结论:胺碘酮对冠心病并SVT者的疗效显著高于毛花甙C。