资源描述:
《小剂量氨茶碱治疗急性颈髓损伤后心动过缓42例.doc》由会员上传分享,免费在线阅读,更多相关内容在工程资料-天天文库。
1、小剂量氨茶碱治疗急性颈髓损伤后心动过缓42例【摘要】目的探讨小剂量氨茶碱对急性颈髓损伤后心动过缓患者的疗效。方法42例急性颈髓损伤后心动过缓患者,首次静脉注射氨茶碱负荷量5mg/kg(10〜30min),之后0.5mg/(kg•h)持续静脉泵注10〜14do治疗期间每2天监测茶碱血药浓度。分析治疗有效率,同时观察和记录患者的呕吐、躁动和抽搐不良反应发生情况。结果42例患者中37例有效,5例无效,有效率为8&10%0治疗后HR(70.00±5.42)次/min,明显高于治疗前(45.00土6.28)次/min(t=23.93,P总
2、之,通过本研究发现小剂量氨茶碱能够有效治疗颈髓损伤患者合并的心动过缓。对于阿托品、肾上腺素效果不好或需要植入心脏起搏器的此类患者,氨茶碱或许是一个可行的选择,但尚需随机对照的大样本研究进一步证实。参考文献[1]LehmannKG,LaneJG,PiepmeierJM,etal.Cardiovascularabnormalitiesaccompanyingacutespinalcordinjuryinhumans:incidence,timecourseandseverity・JAmCollCardiol,1987,10(1):4
3、6-52・[2]VallbonaC,CardusD,SpencerWA,etal.Patternsofsinusarrhythmiainpatientswithlesionsofthecentralnervoussystem・AmJCardiol,1965,16(3):379-389.[1]SaitoD,MatsubaraK,YamanariH,etal.Effectsoforaltheophyllineonsicksinussyndrome・JAmCollCardiol,1993,21(5):1199-1204.[2]Pasn
4、ooriVR,LeesarMA.Useofaminophyllineinthetreatmentofseveresymptomaticbradycardiaresistanttoatropine・CardiolRev,2004,12(2):65-68.[3]Schulz-SttibnerS・Theuseofsmall-dosetheophyllineforthetreatmentofbradycardiainpatientswithspinalcordinjury.AnesthAnalg,2005,101(6):1809-181
5、0.[4]SadakaF,NaydenovSK,PonzilloJJ.Theophyllineforbradycardiasecondarytocervicalspinalcordinjury.NeurocriticalCare,2010,13(3):389-392.[5]Anonymous.2005Americanheartassociationguidelinesforcardiopulmonaryresuscitationandemergencycardiovascularcare:Part7・3:Memagementof
6、symptomaticbradycardiaandtachycardia・Circulation,2005,112(24):IV67-IV77.[1]WinslowEB,LeschM,TaianoJV,etal.Spinalcordinjuriesassociatedwithcardiopulmonarycomplications.Spine,1986,11(8):809-812.[2]BelardinelliL,FentonRA,WestA,etal.Extracellularactionofadenosineandthean
7、tagonismbyaminophyllineontheatrioventricularconductionofisolatedperfusedguineapigandrathearts・CircRes,1982,51(5):569-579・_10]RailTW.Roleofadenosine3',5-monophosphat(cyclicAMP)inactionsofcatecholamines.PharmacolRev,1972,24(2):399-409.[11]AltunA,KirdarC,OzbayG.Effectof
8、aminophyllineinpatientswithatropine-resistaritlateadvancedatrioventricularblockduringacuteinferiormyocardialinfarction・ClinCardiol,