west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "心室颤动" 7 results
  • 心瓣膜置换术后心室颤动的高危因素分析

    目的 探讨心瓣膜置换术后心室颤动(VF) 发生的高危因素及其可能的防治措施. 方法 回顾性收集968例心瓣膜置换术患者的临床资料,按术后是否发生VF分为两组,VF组:58例,术后均发生VF;对照组:从910例未发生VF的患者中随机选择70例作为对照.选择术前临床指标、超声心动图(UCG)、心肺转流术(CPB)、心瓣膜病变类型和术式、术后24小时循环及电解质状况等指标,用Logistic回归方法分析术后发生VF的高危因素. 结果 年龄≥65岁、心胸比率≥0.8、NYHA心功能Ⅳ级、急诊或再次手术、主动脉阻断时间≥120分钟、术后24小时循环不稳定、低钾、低镁等电解质紊乱是其发生的独立危险因素. 结论 VF是心瓣膜置换术后的早期严重并发症;患者的年龄、心脏基础病变的严重程度、围术期的处理可以影响术后VF的发生;早期手术、缩短主动脉阻断时间、维持术后24小时内循环稳定、防止电解质紊乱和缺氧、酸中毒的发生,是预防心瓣膜置换术后VF发生的有效措施.

    Release date:2016-08-30 06:32 Export PDF Favorites Scan
  • Clinical Outcomes of Cold Blood Cardioplegia and Intermittent Cross Clamping as Myocardial Preservation in Coronary Artery Bypass Grafting

    Objective\ In order to assess and evaluate the clinical results of cold blood cardioplegia and intermittent cross clamping as myocardial preservation in coronary artery bypass grafting(CABG).\ Methods\ According to the management methods, 2 013 cases for elective, isolated CABG were divided into two groups at St.George’s Hospital, London.Cold blood cardioplegia group: 596 patients treated with cold blood cardioplegia, and hypothermic ventricular fibrillation group: 1 417 patients treated with intermitt...

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • Surgical Treatment Experience of Emergency Surgery in Treating Rheumatic Valves Patients with Preoperative Ventricular Electrical Storm

    目的探讨成人风湿性心脏瓣膜病术前并发心室电风暴(恶性室性心动过速、心室颤动)行急诊手术的疗效及体会。 方法回顾性分析2004年10月至2014年10月我院成人心脏瓣膜入院后突发恶性室性心动过速、心室颤动的患者6例,其中男2例,女4例,年龄35.0~64.0岁,平均49.8岁。6例患者均为风湿性心脏瓣膜病,二尖瓣中重度狭窄并主动脉瓣及三尖瓣中重度关闭不全2例,二尖瓣中重度关闭不全并三尖瓣中重度关闭不全4例,恶性心律失常发作后立即予艾司洛尔等药物控制,病情基本稳定后急诊手术。其中,行双瓣膜置换+三尖瓣成形术2例,行二尖瓣置换+三尖瓣成形术4例。 结果无围术期患者死亡,术后无心功能显著恶化、无多脏器功能衰竭、无恶性室性心律失常。术后1~2周24 h动态心电图提示室性早搏大于1 000次的2例,室性早搏500~1 000次1例,小于500次的患者3例,短阵室性心动过速2次的患者2例,短阵室性心动过速3次的患者1例。所有6例患者均安全出院,随访6个月至10年,无患者死亡。 结论急诊外科手术联合β受体阻滞剂在治疗成人心脏瓣膜疾病术前突发的反复恶性室性心动过速、心室颤动安全有效。

    Release date: Export PDF Favorites Scan
  • Application of amiodarone in the treatment of intractable ventricular fibrillation following ascending aortic opening in valve replacement: A case control study

    Objective To explore the effect of aortic root perfusion of amiodarone when intractable ventricular fibrillation occurs during valve replacement. Methods Totally 42 patients were selected as a drug group, who underwent intractable ventricular fibrillation following ascending aortic opening in valve replacement in Beijing Anzhen Hospital from October 2006 to October 2016. There were 26 males and 16 females with an average age of 56.31±12.56 years. The aorta was re-blocked when intractable ventricular fibrillation occured, amiodarone (150 mg diluted to 20 ml) through the aortic root perfusion tube was applicated, and suction was repeated 8-10 times with the cumulative amount of 150-200 ml, and then the ascending aorta was opened and fast compressed with a frequency of 200 times/min. While 53 patients with the same condition during the same period were selected as a control group. There were 35 males and 18 females with an average age of 58.79±19.81 years. The commonly used clinical treatment method of intractable ventricular fibrillation was adopted, such as continuous intravenous injection of 1 mg/kg lidocaine, while ascending aortic was re-blocked. The warm blood perfusion was given until the heart re-beated. The clinical outcomes were compared between the two groups. Results There was one perioperative death in the drug group and two deaths in the control group during perioperative period. Defibrillation frequency (3.11±0.59 times vs. 4.91±1.34 times, t=–2.917, P=0.000), heart rate 5 min after re-beating (91.65±9.81 beats/min vs. 98.32±10.21 beats/min, t=–2.019, P=0.032), cardiopulmonary bypass time (71.68±10.21 min vs. 81.59±12.93 min, t=–2.512, P=0.032), dopamine dosage (4.32±1.28 μg·kg–1·min–1 vs. 5.79±1.98 μg·kg–1·min–1, t=–2.781, P=0.015), epinephrine dosage (0.03±0.01 μg·kg–1·min–1 vs. 0.06±0.02 μg·kg–1·min–1, t=–3.996, P=0.000) and norepinephrine dosage (0.01±0.01 μg·kg–1·min–1 vs. 0.03±0.01 μg·kg–1·min–1, t=–4.163, P=0.000) of the drug group were significantly shorter or lower than those of the control group. The rate of cardiac rhythm 5 min after re-beating (42.8% vs. 9.4%, χ2=11.211, P=0.000) of the drug group was higher than that of the control group. Conclusion During intractable ventricular fibrillation following ascending aortic opening in valve replacemen, re-blocking the aorta and amiodarone reperfusion of the aortic root can significantly improve the heart re-beating rate and avoid ventricular re-fibrillation, shorten the cardiopulmonary bypass time and reduce the dosage of inotropic drugs.

    Release date:2018-06-26 05:41 Export PDF Favorites Scan
  • Interpretation of the 2018 Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: The Use of Antiarrhythmic Drugs During Advanced Cardiovascular Life Support and Immediately after Restoration of Spontaneous Circulation in Patients with Cardiac Arrest

    American Heart Association (AHA) updated the advanced cardiovascular life support use of antiarrhythmic drugs during and immediately after cardiac arrest in the AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care in November 2018. Based on the latest progress of relative evidence-based clinical evidence and 2015 AHA guidelines for cardiopulmonary resuscitation and cardiovascular emergency cardiovascular care. This update gave recommends on the use of antiarrhythmic drugs during resuscitation from adult shock-refractory ventricular fibrillation (VF) and pulseless ventricular tachycardia (pVT) cardiac arrest and immediately after restoration of spontaneous circulation following shock-refractory VF/pVT cardiac arrest, respectively. This review aims to interpret this update by reviewing the literature and comparing the recommends in this update with other guidelines.

    Release date:2018-11-22 04:28 Export PDF Favorites Scan
  • 《2020 CCS/CHRS 立场声明:器质性心脏病患者室性心动过速和心室颤动的管理》解读

    Release date:2020-09-22 02:51 Export PDF Favorites Scan
  • Recent advances in external cardiac defibrillation techniques

    As an important medical electronic equipment for the cardioversion of malignant arrhythmia such as ventricular fibrillation and ventricular tachycardia, cardiac external defibrillators have been widely used in the clinics. However, the resuscitation success rate for these patients is still unsatisfied. In this paper, the recent advances of cardiac external defibrillation technologies is reviewed. The potential mechanism of defibrillation, the development of novel defibrillation waveform, the factors that may affect defibrillation outcome, the interaction between defibrillation waveform and ventricular fibrillation waveform, and the individualized patient-specific external defibrillation protocol are analyzed and summarized. We hope that this review can provide helpful reference for the optimization of external defibrillator design and the individualization of clinical application.

    Release date:2021-02-08 06:54 Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content