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目的 探讨再灌注性心室颤动 ( RVF)易发因素、治疗及预后。方法 35 8例接受再灌注疗法的急性心肌梗死 ,其中静脉溶栓 32 2例 ,急症 PTCA36例 ,临床再通者 2 2 1例 ,其中溶栓组 186例 ,急症 PT-CA组 35例 ,临床再通者有 7例发生 RVF,其中溶栓组 6例 ,急症 PTCA组 1例。结果 7例 RVF平均年龄为 41.6± 2 .8岁 ,胸痛至再灌注时间为 3.2± 0 .8小时 ,RVF发生前多无恶性心律失常等先兆 ,闭塞部位于冠状动脉近端 ,开通后残余轻 ,随访 2 3.3月无心室颤动复发。结论 心肌梗死时缺血范围大 ,再灌注时间早 ,再灌注流量大 ,是 RVF的易发因素 ,电转复是有效的治疗方法。随访期间无心室颤动复发 ,预后良好
Objective To investigate the risk factors, treatment and prognosis of reperfusion ventricular fibrillation (RVF). Methods A total of 358 acute myocardial infarction patients undergoing reperfusion therapy were enrolled in this study. Among them, 32 were thrombolytic therapy, 36 were emergency PTCA, and 221 were clinically recurrent. Among them, 186 were thrombolytic group, 35 were PT-CA group, Recanalization occurred in 7 cases of RVF, including 6 cases of thrombolytic group, emergency PTCA group 1 case. Results The average age of 7 RVFs was 41.6 ± 2. 8 years old. The duration of chest pain to reperfusion was 3.2 ± 0.8 hours. Before RVF, there were no more arousals such as malignant arrhythmia. The occlusion was located in the proximal coronary artery. , Followed up for 23.3 months without ventricular fibrillation recurrence. Conclusion Myocardial infarction with a large range of ischemia, reperfusion time, reperfusion flow rate is a risk factor for RVF, electrical conversion is an effective treatment. No ventricular fibrillation recurrence during follow-up, the prognosis is good