胺碘酮联合利多卡因治疗心室电风暴16例疗效评价

目的 观察当胺碘酮治疗心室电风暴效果不佳时,联合利多卡因治疗的安全性与疗效.方法 2009年6月至2012年6月在我院重症医学科住院的发生心室电风暴且均使用胺碘酮治疗但效果不佳的16例患者,在使用胺碘酮的基础上联合使用利多卡因治疗,分析其安全性及疗效.结果 有9例（56.3％）患者转复窦性心律后未再出现室性心动过速（室速）或心室颤动（室颤）.3例（18.8％）患者仍有短阵室速发作,但室速对血流动力学影响不大.2例（12.5％）患者仍有室颤发作1次,再次电复律后无室速或室颤发作,2例（12.5％）患者反复室颤发作不能控制而死亡.胺碘酮联合利多卡因治疗心室电风暴总有效率为87.5％ （14/16）.16例病例中,1例（6.3％）病例出现窦性心动过缓,1例（6.3％）病例出现低血压.结论 对胺碘酮治疗效果不佳的心室电风暴,应用胺碘酮联合利多卡因治疗安全有效.

Clinical analysis of amiodarone combined with lidocaine in the treatment of ventricular electrical storm

Objective To evaluate the curative effect and security of amiodarone combined with lidocaine in the treatment ofventricular electrical storm. Methods Sixteen patients with ventrieular electrical storm were subject- ed to the treatment of amiodarone from June 2009 to June 2012, but the treatment were found to be inefficacious. The 16 patients were then treated with lidocaine on basis of amiodarone, the clinical effect and security of the treatment were analyzed. Results Among the 16 patients, 9 （56.3%） were converted into sinus rhythm and there was no ventric- ular tachyeardia or ventricular fibrillation occurred anymore. Three patients （18.8%） had paroxysmal ventrieular tachycardia and had no influence on hemodynamie. Two patients （12.5%） had ventricular fibrillation, but they were converted into sinus rhythm by electric cardioversion. Two patients （12.5%） died because of ventricular fibrillation fre- quently. The total effective rate reaebed 87.5%. Among the 16 patients, one （6.3%） occurred sinus bradycardia, and an- other one （6.3%） occurred hypotension. Conclusion When amiodarone is found to be not efficacious for the patients with ventricular electrical storm, treatment of amiodarone combined with lidocaine can be safe and effective.