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目的探讨老年心功能不全伴心房颤动患者静脉用胺碘酮治疗的用药安全。方法对76例老年心功能不全伴心房颤动患者静脉用胺碘酮时进行用药前评估;用药方案正确实施;用药后疗效判断;用药后不良反应观察与处理4个方面进行评估与观察。结果76例老年心功能不全伴心房颤动患者静脉用胺碘酮治疗,阵发性心房颤动52例,持续心房颤动24例。复律成功55例(72%),未转复为窦性心律21例(28%)。13例(17%)患者出现低血压,立即停止静脉用胺碘酮并使用升压药物多巴胺干预后恢复正常。7例(9%)患者应用胺碘酮转为窦性心律后,出现窦性心动过缓,4例患者出现快慢综合征,3例患者出现间歇性的慢心室率(长R-R间期)。7例(9.21%)患者停静脉用胺碘酮后给予阿托品药物治疗,4例患者心率恢复正常,有3例患者安装永久性心脏起搏器。结论加强对老年心功能不全伴心房颤动患者,静脉用胺碘酮治疗的评估与观察。早期发现不良反应及时处理,对患者用药安全有重要的意义。
Objective To investigate the safety of intravenous amiodarone in elderly patients with cardiac dysfunction and atrial fibrillation. Methods 76 cases of elderly patients with atrial fibrillation in patients with atrial fibrillation before intravenous amiodarone pre-medication evaluation; the correct implementation of drug regimens; treatment efficacy judgment; observation and treatment of adverse reactions after treatment evaluation and observation. Results 76 cases of elderly patients with cardiac dysfunction and atrial fibrillation were treated with intravenous amiodarone, paroxysmal atrial fibrillation in 52 cases, sustained atrial fibrillation in 24 cases. 55 cases (72%) had successful cardioversion, and 21 cases (28%) had no sinus rhythm. Thirteen (17%) patients developed hypotension and immediately stopped intravenous amiodarone and returned to normal after intervention with the antihypertensive drug, dopamine. In 7 patients (9%), sinus bradycardia occurred after conversion of amiodarone to sinus rhythm. Four patients developed Hypochondriasis syndrome and three patients experienced intermittent slow ventricular rate (long R-R interval). Seven patients (9.21%) received intravenous atropine after amiodarone, 4 patients had normal heart rate, and 3 patients had permanent pacemakers. Conclusion To strengthen the evaluation and observation of amiodarone in elderly patients with cardiac dysfunction and atrial fibrillation. Early detection of adverse reactions in a timely manner, the patient medication safety is of great significance.