艾司洛尔、胺碘酮和地尔硫卓应用于麻醉期间快室率房颤中的疗效及安全性比较(1)
【摘要】 目的 比較艾司洛尔、胺碘酮和地尔硫卓应用于麻醉期间快室率心房颤动(房颤)中的疗效及安全性。方法 81例麻醉期间快室率房颤患者， 随机分为艾司洛尔组(A组)、胺碘酮组(B组)和地尔硫卓组(C组)， 每组27例。A组以0.5 mg/kg艾司洛尔1 min内静脉注射， 再以0.05 mg/(kg·min) 静脉泵注维持;B组以3 mg/kg胺碘酮10 min内静脉注射， 再以1 mg/min静脉泵注维持;C组以0.25 mg/kg
地尔硫卓5 min内静脉注射， 10 min后无效者追加1次。比较三组患者用药前及用药后10、15、30、60、90 min的心室率、平均起效时间、有效率和不良反应发生情况。结果 A组、B组、C组的平均起效时间分别为(4.5±1.2)、(17.5±7.2)、(9.5±3.4)min， A组平均起效时间短于B组、C组， C组短于B组， 差异具有统计学意义(P<0.05)。用药后10 min， 三组有效率比较差异具有统计学意义(P<0.05);用药后30 min， A组、C组有效率均高于B组， 差异具有统计学意义(P<0.05);用药后10、15、30、60、90 min， 三组心室率均低于本组用药前， 差异具有统计学意义(P<0.05);用药后30 min， A组心室率低于B组、C组， C组低于B组， 差异具有统计学意义(P<0.05);用药后15、30 min， A组、C组心室率均低于B组， 差异具有统计学意义(P<0.05);B组用药后不良反应发生率11.1%低于A组的37.0%、C组的33.3%， 差异具有统计学意义(P<0.05)。结论 艾司洛尔、胺碘酮和地尔硫卓均对麻醉期间快室率房颤安全有效， 其中艾司洛尔起效最快， 胺碘酮使用最安全。
【关键词】 艾司洛尔;胺碘酮;地尔硫卓;心房颤动;心室率
DOI：10.14163/j.cnki.11-5547/r.2020.21.047
Comparison of efficacy and safety of esmolol， amiodarone and diltiazem in rapid ventricular rate atrial fibrillation during anesthesia ZHANG Chun-mei. Department of Pharmacy， Shenyang 245 Hospital， Shenyang 110043， China
【Abstract】 Objective To compare the efficacy and safety of esmolol， amiodarone and diltiazem in rapid ventricular rate atrial fibrillation during anesthesia. Methods A total of 81 patients with rapid ventricular rate atrial fibrillation during anesthesia were randomly divided into esmolol group (group A)， amiodarone group (group B) and diltiazem group (group C)， with 27 cases in each group. Group A received intravenous injection of 0.5 mg/kg
esmolol within 1 min， and then maintained by intravenous injection of 0.05 mg/(kg·min). Group B received intravenous injection of 3 mg/kg amiodarone within 10 min， and then maintained by intravenous injection of
1 mg/min. Group C received intravenous injection of 0.25 mg/kg diltiazem within 5 min， and the invalid was added once after 10 min. The ventricular rate， mean onset time， effective rate before administration and 10， 15， 30， 60 and 90 min after administration and occurrence of adverse reactions were compared among the three groups. Results The mean onset time of group A， group B and group C were (4.5±1.2)， (17.5±7.2) and (9.5±3.4) min respectively. The mean onset time of group A was shorter than those of group B and group C， and group C was shorter than that of group B， and the difference was statistically significant (P<0.05). 10 min after administration， there was statistically significant difference in effective rate among the three groups (P<0.05). 30 min after administration， the effective rate of group A and group C was higher than that of group B， and the difference was statistically significant (P<0.05). 10， 15， 30， 60 and 90 min after administration， the ventricular rate of the three groups were lower than those before administration， and the difference was statistically significant (P<0.05)., 百拇医药(张春梅)
地尔硫卓5 min内静脉注射， 10 min后无效者追加1次。比较三组患者用药前及用药后10、15、30、60、90 min的心室率、平均起效时间、有效率和不良反应发生情况。结果 A组、B组、C组的平均起效时间分别为(4.5±1.2)、(17.5±7.2)、(9.5±3.4)min， A组平均起效时间短于B组、C组， C组短于B组， 差异具有统计学意义(P<0.05)。用药后10 min， 三组有效率比较差异具有统计学意义(P<0.05);用药后30 min， A组、C组有效率均高于B组， 差异具有统计学意义(P<0.05);用药后10、15、30、60、90 min， 三组心室率均低于本组用药前， 差异具有统计学意义(P<0.05);用药后30 min， A组心室率低于B组、C组， C组低于B组， 差异具有统计学意义(P<0.05);用药后15、30 min， A组、C组心室率均低于B组， 差异具有统计学意义(P<0.05);B组用药后不良反应发生率11.1%低于A组的37.0%、C组的33.3%， 差异具有统计学意义(P<0.05)。结论 艾司洛尔、胺碘酮和地尔硫卓均对麻醉期间快室率房颤安全有效， 其中艾司洛尔起效最快， 胺碘酮使用最安全。
【关键词】 艾司洛尔;胺碘酮;地尔硫卓;心房颤动;心室率
DOI：10.14163/j.cnki.11-5547/r.2020.21.047
Comparison of efficacy and safety of esmolol， amiodarone and diltiazem in rapid ventricular rate atrial fibrillation during anesthesia ZHANG Chun-mei. Department of Pharmacy， Shenyang 245 Hospital， Shenyang 110043， China
【Abstract】 Objective To compare the efficacy and safety of esmolol， amiodarone and diltiazem in rapid ventricular rate atrial fibrillation during anesthesia. Methods A total of 81 patients with rapid ventricular rate atrial fibrillation during anesthesia were randomly divided into esmolol group (group A)， amiodarone group (group B) and diltiazem group (group C)， with 27 cases in each group. Group A received intravenous injection of 0.5 mg/kg
esmolol within 1 min， and then maintained by intravenous injection of 0.05 mg/(kg·min). Group B received intravenous injection of 3 mg/kg amiodarone within 10 min， and then maintained by intravenous injection of
1 mg/min. Group C received intravenous injection of 0.25 mg/kg diltiazem within 5 min， and the invalid was added once after 10 min. The ventricular rate， mean onset time， effective rate before administration and 10， 15， 30， 60 and 90 min after administration and occurrence of adverse reactions were compared among the three groups. Results The mean onset time of group A， group B and group C were (4.5±1.2)， (17.5±7.2) and (9.5±3.4) min respectively. The mean onset time of group A was shorter than those of group B and group C， and group C was shorter than that of group B， and the difference was statistically significant (P<0.05). 10 min after administration， there was statistically significant difference in effective rate among the three groups (P<0.05). 30 min after administration， the effective rate of group A and group C was higher than that of group B， and the difference was statistically significant (P<0.05). 10， 15， 30， 60 and 90 min after administration， the ventricular rate of the three groups were lower than those before administration， and the difference was statistically significant (P<0.05)., 百拇医药(张春梅)