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目的 比较不同种类药物的转复率、心室率控制情况及药物应用的安全性与有效性,并对直流电转复治疗的选择进行探讨。方法 总结57例老年人阵发性房颤的临床复律治疗资料,分别给予毛花苷丙(西地兰)及不影响不应期的钠通道阻滞剂类药物普罗帕酮,观察转复及心率控制情况,对合并严重并发症、药物控制无效的患者,给予同步直流电复律。结果 毛花苷丙24 h内急诊转复率28.1%,安静状态下心室率控制满意;普罗帕酮24 h内急诊转复率62.2%,心室率控制满意,两者疗效比较差异有显著性(P<0.01);直流电复率组即刻转复率为73.3%,心室率控制不满意。结论普罗帕酮较毛花苷丙的急诊转复率明显提高,对危急患者同步直流电转复为有效的治疗方法,但需谨慎应用。
Objective To compare the different types of drugs, the rate of recovery, ventricular rate control and the safety and effectiveness of drug use, and the choice of DC rehabilitation treatment. Methods The clinical data of 57 patients with paroxysmal atrial fibrillation (AF) were summarized and compared with that of cinidonide (cedilanid) and propafenone (sodium channel blocker), which did not affect the refractory period. And heart rate control, for patients with serious complications, drug control invalid, to give synchronous DC cardioversion. The results showed that succinyl glycosides C within 24 h emergency recovery rate of 28.1%, quiet ventricular rate control satisfaction; propafenone within 24 h of emergency rehabilitation rate was 62.2%, ventricular rate was satisfactory, the difference between the two was significant ( P <0.01). The immediate recovery rate in DCR group was 73.3%, and ventricular rate control was not satisfied. Conclusions The recovery rate of propafenone compared with mahoglycoside C is significantly higher than that of malitosin C, and it is an effective treatment for synchronous DC in critically ill patients, but caution should be applied.