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目的比较普罗帕酮、胺碘酮、普罗帕酮、三磷腺苷(ATP)、艾司洛尔治疗阵发性室上性心动过速(PSVT)的临床疗效及安全性。方法选取新疆生产建设兵团医院急诊科2014年1月—2016年5月收治的PSVT患者250例,随机将所有患者分为普罗帕酮组、胺碘酮组、普罗帕酮组、ATP组和艾司洛尔组,各50例。普罗帕酮组患者给予0.9%氯化钠溶液+普罗帕酮治疗;胺碘酮组患者给予0.9%氯化钠溶液+胺碘酮治疗;普罗帕酮组患者给予0.9%氯化钠溶液+普罗帕酮治疗;ATP组患者给予ATP治疗;艾司洛尔组给予艾司洛尔治疗。比较5组患者复律成功率及不良反应发生情况,并比较5组患者治疗前后血压及心率,记录比较5组患者转复时间。结果 ATP组患者复律成功率、不良反应发生率高于其他4组(P<0.05),普罗哌酮组患者不良反应发生率高于胺碘酮组(P<0.05)。治疗前及治疗后,5组患者舒张压、收缩压及心率比较,差异无统计学意义(P<0.05);两组患者治疗后舒张压、收缩压及心率低于治疗前(P<0.05)。ATP组复律时间短于普罗帕酮组、胺碘酮组、普罗帕酮组及艾司洛尔组(P<0.05)。结论 ATP治疗PSVT的临床疗效优于普罗帕酮、胺碘酮、普罗帕酮及艾司洛尔,复律时间短,但其不良反应也较高,因此在急诊治疗时需结合患者的身体耐受力、病史等选择有效且安全的药物。
Objective To compare the clinical efficacy and safety of propafenone, amiodarone, propafenone, adenosine triphosphate (ATP) and esmolol in the treatment of paroxysmal supraventricular tachycardia (PSVT). Methods 250 cases of PSVT patients who were admitted to Emergency Department of Xinjiang Production and Construction Corps Hospital from January 2014 to May 2016 were randomly divided into propafenone group, amiodarone group, propafenone group, ATP group and Ai In the mitoxol group, 50 cases each. Patients in the propafenone group were treated with 0.9% sodium chloride solution plus propafenone; patients in the amiodarone group were treated with 0.9% sodium chloride solution plus amiodarone; patients in the propafenone group were given 0.9% sodium chloride solution plus propofol ATP treatment in patients in ATP group and esmolol treatment in esmolol group. The success rate of cardioversion and adverse reactions in 5 groups were compared. The blood pressure and heart rate of 5 groups were compared before and after treatment. The recovery time of 5 groups was recorded. Results The success rate of cardioversion and incidence of adverse reactions in ATP group were higher than those in the other four groups (P <0.05). The incidence of adverse reactions in the prohexadone group was higher than that in the amiodarone group (P <0.05). Before treatment and after treatment, there was no significant difference in diastolic blood pressure, systolic blood pressure and heart rate between the five groups (P <0.05). The diastolic blood pressure, systolic blood pressure and heart rate of the two groups were lower than before treatment (P <0.05) . Cardioversion time in ATP group was shorter than that in propafenone group, amiodarone group, propafenone group and esmolol group (P <0.05). Conclusions The clinical efficacy of ATP in the treatment of PSVT is better than that of propafenone, amiodarone, propafenone and esmolol, and the cardioversion time is short, but its adverse reactions are also high. Therefore, in the emergency treatment, the patient’s body resistance Force, history and other effective and safe choice of drugs.