卢才义 毛树森 刘朝中 王文清 魏璇 黄丛春 张红 空军心血管病研究中心、空军总医院心内科(北京 100036) 中国心脏起搏与心电生理杂志 1999 0 13 4


    关键词：心室颤动；猝死；随访 期刊 zgxzqbyxdslzz 0 临床论著 fur -->


    

率，对连续58例经心电监测或心电图证实的室颤住院者进行回顾分析和随访。心功能评价采用NYHA 4级分类法。男37例(68±19岁)、女11例(64±17岁)。35例室颤发生于CCU病房、15例发生于心导管室、3例发生于抢救室、5例发生于普通病房。58例中复苏失败死亡者16例，除颤成功后72 h内死亡4例，存活出院38例。室颤发生于心肌梗死(简称心梗)急性期7例(12%)，复苏成功6例(86%)。发生于非急性心梗51例(88%)，其中陈旧性心梗25例(复苏成功72%)、冠心病12例(复苏成功100%)。其他病因14例，多为晚期慢性心功能不全者(复苏成功14%)。20例住院期间死亡者和38例存活出院者中分别有90%和42%心功能异常。失访3例(8%)，其余35例随访6±3(1～9)年，其中5例死亡(14%)，2例为猝死(6%)，长期服用抗心律失常药物者4例(11%)。结论：急性心梗和心导管操作引起的室颤抢救成功率高(86%～100%)，晚期心脏病室颤抢救成功率低(14%)，除颤早晚和心功能损害程度明显影响抢救成功率和远期存活率。

Clinical Evaluation of 58 Cases of Ventricular Fibrillation

Lu Caiyi,Mao Shusen,Liu Chaozhong,et al

    (Air Force General Hospital,Beijing,100036)

Abstract The course and long-term survival of in-hospital ventricular fibrillation (VF) were evaluated retrospectively.The clinical data and fellow-up results of 58 patients (pts) with VF recorded during electrocardiogram (ECG) monitoring or confirmed by emergency bedside ECG recordings were analyzed.Cardiac function was evaluated in NYHA criteria.The fifty-eight pts were 37 males (68±19 yrs) and 11 females (64±17 yrs).Thirty-five VFs occurred in CCU,5 in word and 15 in catheterization room.16/58 cases died because of cardiac pulmonal resuscitation (CPR) failure.Four cases died in 72 hours after successful derect current (DC) defibrillation.Thirty-eight pts were survival after CPR.Seven VFs (12% ) were evoked during acute myocardial infarction and 6/7 was successfully resuscitated.Others were due to previous myocardial infarction (25/51,successful CPR 72% ),coronary heart disease (12/51,successful CPR 100% ) and advanced heart failure (14/51,successful CPR 14% ).There were severe heart failure in 18/20 death pts and 16/38 survival pts.Altogether 35 pts were followed in 6±3(1～ 9) years.Five of them were died and four adopted chronic antiarrhythmic therapy.Conclusions:The success rate of resuscitation was 86% in VFs occurred in acute myocardial infarction,100% in VFs evoked during catheterization procedures and only 14% in VFs developed in advanced heart disease.DC defibrillation time and heart dysfunction degree is very important to successful resuscitation and long-term survival rate.

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