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|本期目录/Table of Contents|

地尔硫卓预防肺切除术后房性心律失常的效果

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第1期
页码:
58-061
栏目:
临床研究
出版日期:
2014-09-25

文章信息/Info

Title:
Effects of diltiazem prophylaxis on incidence of atrial arrhythmias after pulmonary surgery
作者:
何庚戌1; 要彤2; 王春光2; 李海英1; 濮仁富1; 周 峰1; 蔡宝松1
(1.解放军第251医院胸心血管外科，河北 张家口 075000；
2.河北省北方学院第一附属医院心电图室，河北 张家口 075000)
Author(s):
HE Geng-xu1;  YAO Tong2;  WANG Chun-guang2;  LI Hai-ying1;  PU Ren-fu1;  ZHOU Feng1;  CAI Bao-song1
(1.Department of Thoracic and Cardiovascular Surgery, PLA 251 Hospital, Zhangjiakou 075000, Hebei, China;
2.Department of Electrocardiogram, First Affiliated Hospital of North College, Zhangjiakou 075000, Hebei, China)
关键词:
肺切除术; 心律失常; 心房颤动; 地尔硫卓
Keywords:
Lobectomy;  arrythmia;  atrial fibrillation;  diltiazem
分类号:
R541.61
DOI:
-
文献标识码:
A
摘要:
目的:观察预防性应用钙离子拮抗剂地尔硫卓能否降低肺切除术后心房颤动（或）心房扑动及其并发症的发生率。方法： 从2007年~2011年接受肺叶切除患者341例，采用随机对照双盲试验，其中169例患者给予术前口服、术后进食后即开始口服地尔硫卓， 直至术后14 d；安慰剂组172例患者。观察的终点是对治疗期间持续房颤或临床症状明显的房性心律失常的治疗效果。结果： 在地尔硫卓治疗组房颤或房扑的发生率［10.6%(20/169)］较对照组［19.8%(36/172)］显著降低（P<0.05)；房颤发生的患者中地尔硫卓治疗组的平均心率较安慰剂组也显著降低。但两组之间在术后主要并发症及住院时间均无显著差异。无明显的与口服地尔硫卓相关的并发症出现。结论： 预防性口服地尔硫卓可以显著降低胸外科手术后患者房性心律失常的发生率。
Abstract:
AIM:To evaluate whether early prophylaxis with calcium channel blocker reduces the incidence and morbidity associated with atrial arrhythmias after major thoracic surgery. METHODS: In this randomized, double-blinded and placebo-controlled study, 341 patients were given diltiazem or placebo orally before and immediately after lobectomy (169/172) and thereafter for 14 days. The primary end point with respect to efficacy was a sustained ≥15 min or clinically significant atrial arrhythmia during treatment. RESULTS: Postoperative atrial arrhythmias incidence in the diltiazem group was significantly lower compared to the placebo group, with nearly a 50% reduction of the incidence of clinically significant arrhythmias. The maximal ventricular rate during AF in the diltiazem group was significantly lower than in the placebo group. No significant difference was observed in the incidence of postoperative complications and the length of hospital stay between groups. There were no serious adverse effects caused by diltiazem. CONCLUSION: Prophylactic diltiazem reduces the incidence of clinically significant atrial arrythmias in patients at high risk for this complication after major thoracic operations.

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备注/Memo

备注/Memo:
收稿日期：2013-11-25.
作者简介：何庚戌，副主任医师，博士Email：hegengxu@yahoo.com.cn
更新日期/Last Update: 2015-01-20