新生儿心律失常43例临床分析

目的：探讨新生儿心律失常的病因、治疗及预后。方法：回顾分析43例经心电图确诊的新生儿心律失常的临床特点、病因、治疗及疗效。结果：本组发病率0．191％。窒息缺氧及感染为主要病因占69.8％。治疗总有效率86％。结论：对本病应加强围生期保健;重症者要强调心电监护;治疗应视具体情况采取对因、对症或进一步观察等综合措施;预后大多良好。     

次极量活动平板运动试验QTc离散度与心律失常的关系

目的 :探讨在次极量活动平板运动试验中 QTc离散度与心律失常的关系。方法 :观察 174例患者活动平板运动试验后有无心肌缺血性心律失常并测量 QTc离散度。结果 :次极量活动平板运动试验阳性者 70例 ,其 QTc离散度明显增大 ,而且 70 %出现心律失常。而阴性组 Q- T离散度不增大 ,仅 2例出现房早。结论 :QTc离散度可以作为次极量活动平板运动试验预测心律失常的一个参考条件     

动态心电图与常规心电图诊断冠心病患者心律失常的比较

目的 探讨运用动态心电图诊断冠心病患者心律失常临床意义。方法 对56例冠心病患者采用动态心电图和常规心电目监测与诊断,并将诊断结果进行比较分析。结果 2种方法的诊断阳性率对比无显著差异（P〉0．05）,但是动态心电图对试组冠心病病人心律失常检出率及心律失常的检出程度均高于常规心电图（P〈0．05）。结论 动态心电图是临床上发现冠心病患者心律失常重要的有效的诊断工具。     

Multifocal or chaotic atrial rhythm

Summary Nine infants with episodic or continuous chaotic atrial rhythm (CAR) are presented. In addition to 3 or more different P-wave contours, atrial rates greater than 100 per minute, variable PP, RR, and PR intervals, and a discrete isoelectric baseline, findings included atrial rates that varied from a low of 50 to 120 to a high of 140 to 270 per minute, ventricular rates that varied from a low of 40 to 50 to a high of 180 to 270 per minute, and periodic sinus arrest with junctional escape rhythm. Except for the arrhythmia, all had a normal cardiac examination, ECG, chest x-ray film, and echocardiogram. Six infants were otherwise normal; one had an orbital rhabdomyosarcoma; one had neonatal asphyxia; and one had respiratory distress, bronchopulmonary dysplasia, and an intraventricular cerebral hemorrhage. The CAR persisted from 3 days to 20 months; it spontaneously reverted to normal sinus rhythm in 8 infants and persists in 1 infant at age 7 months. Digoxin (4 patients), propranolol hydrochloride (3 patients), quinidine sulfate (2 patients), and lidocaine (1 patient) did not alter the CAR. No patient had heart failure secondary to the CAR, although three also had episodes of sustained atrial tachycardia, which while present caused heart failure. All patients are functioning normally at home and have normal findings on cardiac examination and have normal ECGs at ages 3 to 38 months. Seven are in normal sinus rhythm, one has rare atrial premature contractions, and one has persistent CAR. We conclude that specific treatment was not necessary in these infants with CAR, except in those with associated sustained atrial tachycardia, which itself may cause heart failure.     

经腹腔镜胆囊切除术CO2气腹期间出现心律失常的临床分析

本文分析了 5 4例经腹腔镜手术CO2 气腹期间出现心律失常的发生机制及防治办法。 5 4例中 ,术前心电图异常者 5例 ,包括心肌缺血、心肌劳损、ST段改变、心动过缓及右束支传导阻滞。故应注意 :①术前常规应用抗胆碱药 ;②麻醉药应选择对循环影响轻及短效药物 ;③人工气腹过程中应监测血压和心电 ;④注入CO2 时 ,应速度缓慢。     

100例急性心肌梗塞并发心律失常的临床分析

急性心肌梗塞（AMI）常伴有严重的心律失常,是AMI猝死的原因之一,为早期了解AMI各种心律失常的变化及临床意义,总结治疗经验,减少死亡率,现将我院1999-2009年来收治的100例AMI并发心律失常进行分析如下。     

3627例心电图的心律失常分析

本文对1983—1990年我院心内科住院病人发生心律失常3627例进行分析。结果表明,过早搏动、心房纤颤及窦性心动过缓的构成比明显增高;窦性心律失常在20—29岁年龄组中发生最高且男多于女;传导失常在50—59岁年龄组中男性明显多于女性,在60—69岁年龄组中则女性多于男性;室性过早搏动多发生于冠心病、心肌病及风湿性心脏病;心房纤颤多发于风湿性心脏病和冠心病;窦性心动过缓多发于冠心病和高血压性心脏病。心电图心律失常构成比心脏病。     

浅谈参松养心胶囊治疗心律失常疗效观察

目的：观察参松心胶囊,对心律失常的疗效.方法：回顾性分析我院门诊2008年3月-2010年3月心律失常患者40例,口服参松养心胶囊每次4粒,每日3次,按病情调整剂量,疗程4周.患者用药前后做心电图和24h动态心电图检查.结果：治疗组有效率85%;对患者肝、肾功能和电解质及胃肠道无不良影响.结论：参松养心胶囊是我们临床工作者运用中西医结合治疗心律失常的理想药物,也为我们治疗心律失常多提供了一种手段.松养心胶囊用于治疗心律失常疗效确切,安全,无毒副作用.值得在临床上推广应用.     

Effect of comorbidities on clinical outcome of patients with burn injury — An analysis of the German Burn Registry

BackgroundSevere burn injuries are associated with high morbidity and mortality. Well-implemented scoring systems for patients with major burns exist in the literature. A major disadvantage of these scores is the partial non-consideration of patient-related comorbidities. Published data on this matter is limited to small study cohorts and/or single center studies. Further, the effect of comorbidities on clinical outcome of patients with severe burn injuries has not yet been examined nationwide in a large cohort in Germany. Hence, the aim of this study was to examine the influence of comorbidities on clinical outcome of these patients based on data from the national registry.MethodsAnonymized data from a total of 3455 patients with documented burns of 1% or more Total Burn Surface Area (TBSA) and over 16 years of age included in the German Burn Registry between 2017 and 2018 were analyzed retrospectively. Data included burn extent, body weight, age, burn depth, inhalation injury, comorbidities, mortality, number of operations and length of hospital stay (LOS).ResultsIn the logistic regression analysis age (OR 1.07 [1.06–1.09], p < 0.001), TBSA (OR 1.09 [1.08–1.11], p < 0.001), IHT (OR 2.15 [1.44–3.20], p < 0001), third degree burn (OR 2.08 [1.39–3.11], p < 0.001), Chronic Obstructive Pulmonary Disease (COPD) (OR 2.45 [1.38–4.35], p = 0.002) and renal insufficiency (OR 2.02 [1.13–3.59], p = 0.017) influenced mortality significantly. If a patient had more than one comorbidity, mortality was higher and in-hospital length of stay (LOS) longer. Renal insufficiency was significantly (p < 0.001) associated with the most prolonged LOS by 11.44 days. TBSA (p < 0.001), Abbreviated Burn Severity Index (ABSI) > 3 (p < 0.001) and IHT (p = 0.001) correlated with the amount of required surgeries and significantly predicted the need for intubation. Patients with arrhythmia significantly required more surgeries (p = 0.041), whereas patients with COPD required significantly less surgical interventions (p = 0.013).ConclusionPreexisting comorbidities have a significant impact on the clinical outcome of patients with severe burn injuries. Further investigation is warranted in order to supplement existing prognostic scores with new mortality-associated parameters.     

稳心颗粒治疗心律失常的疗效观察

目的观察稳心颗粒治疗心律失常的临床疗效及不良反应。方法选择80例心律失常的病人,口服稳心颗粒1袋(9g)/次,3次/d,4周为1个疗程。结果临床症状改善总有效率91.25%,心电图改善总有效率83.75%。结论稳心颗粒治疗心律失常的疗效较好且安全。