目的 分析总结衡水市第四人民医院心室电风暴(VES)病例的病因、抢救方法、注意事项及转归.方法 回顾性分析衡水市第四人民医院心内科收治的24例VES患者的临床资料、心电图资料和随访资料.结果 所有病例中急性冠脉综合征14例,缺血性心肌病1例,扩张性心肌病3例,病态窦房结综合征3例,三度房室传导阻滞1例,Brugada综合征1例,急性重症胰腺炎1例.所有患者均给予电除颤或电复律治疗,14例接受治疗经皮冠状动脉介入治疗,4例植入永久起搏器,1例植入埋藏式心律转复除颤器.抢救成功18例.随访2年中2例患者于院外猝死.结论 冠状动脉粥样硬化性心脏病(冠心病)是心室电风暴的主要原因和诱因,急性发作期以电除颤和电复律为主,药物治疗首选艾司洛尔静脉注射.病情稳定后应消除引起电风暴的病理基础,必要时植入埋藏式心律转复除颤器和射频消融治疗.%Objective To analyze the disease causes, rescue methods, matters needing attention and prognosis of cases of ventricular electrical storm (VES).Methods The materials of clinic, electrocardiogram and follow-up were retrospectively analyzed from 24 VES patients in the Department of Cardiology of the Fourth People' s Hospital of Hengshui City.Results Among all cases, there were 14 cases of acute coronary syndrome, 1 of ischemic cardiomyopathy, 3 of dilated cardiomyopathy, 3 of sick sinus syndrome, 1 of third-degree atrioventricular block, 1 of Brugada syndrome and 1 of severe acute pancreatitis. All patients were given the treatment of electric defibrillation or electrical cardiovension, and there were 14 cases received percutaneous coronary intervention, 4, implantation of permanent pacemaker, and 1, implantable cardioverter defibrillator (ICD). There were 18 cases rescued successfully. There were 2 cases died suddenly during 2-year follow-up period.Conclusion Coronary heart disease is the major cause and inducement of VES, which can be treated with electric defibrillation or electrical cardiovension during acute attack, and the first-choice drug is intravenous injection of esmolol. When the condition is stable, the pathological basis of VES should be eliminated, and on occasion, ICD and radiofrequency ablation can be used in treatment.
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