đánh giá hiệu quả của verapamil và amiodarone điều trị đơn độc hoặc phối hợp qua đường tĩnh mạch trong nhịp nhanh kịch phát trên thất có phức bộ qrs hẹp tại bệnh viện hương trà năm 2010 2011

534
U QU CU TR C
HOC PHI HCH TRONG NHP NHANH KCH PHÁT
TRÊN THT CÓ PHC B QRS HP TI BNH VI- 2011

Nguyc Hoàng
1
, Nguyn
2

1
,

3

1

2
1
Bnh via Thiên Hu;
2
i hc Hu;
3
Bệnh viện đa khoa tỉnh Thừa Thiên Huế

TÓ
: 

: n

: 








n



SUMMARY
EFFICIENCY RATING OF VERAPAMIL AND AMIODARONE IN ALONE OR
COMBINE TREATMENT BY VEIN IN SUPRA-VENTRICULAR TACHYCARDIA
WITH NARROW-QRS COMPLEX AT HUONG TRA HOSPITAL 2010 - 2011 YEAR
Objectives: Efficiency rating of verapamil and amiodarone in alone or combine treatment by
vein in supra-ventricular tachycardia with narrow-QRS complex.
Subject and method: We Studied 45 case supra-ventricular tachycardia with narrow-QRS
complex. Efficiency rating of verapamil and amiodarone in alone or combine treatment by vein
in supra-ventricular tachycardia with narrow-QRS complex.
Results: All patients admited at Huong Tra hospital, whom always signs: thrilling, heart pounding.
Supra-ventricular tachycardia with narrow-QRS complex have got rate 60%, while narrow-
QRS complex regular have rate 54,67%, narrow-QRS complex irregular have rate 5,33%. Supra-
ventricular tachycardia with wide-QRS complex have got rate 40%. There have got three case
(7,67%) supra-ventricular tachycardia with narrow-QRS complex effected blood presure. Supra-
ventricular tachycardia with narrow-QRS complex have been decreased to come after 40 age.
Combine verapamil and amiodarone treatment by vein in supra-ventricular tachycardia with
narrow-QRS complex had been to high effect when comparison alone treatment verapamil or
amiodarone (p<0,001).


 



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
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535
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
  
- y
-





 

- 

               


 




- 
[2],[7]:
- 
- Choáng tim.
- 
- Block A-V II, III.
- 
- 
- 
-  
            

- -
-  -Parkinson-

- 
- -adrenergic.
u

- 
- 
- 
 [2],[8]
- -
- 
- 
- -
-
- 


- 
536
- 
- 





-  

-  
- 

- 

[2],[8]


- 
- 
- 
- ác.
- 


- 
- 
- 

- 
- - - 
- 
- 

537



-15 giây.




- 
- 
-        

- 

 Verapamil (Is--10
-30 phút.
 Amiodarone 
út.
Nhóm 3 
Verapamil --
duy trì Amiodarone 

Chún



 





- 







140-
<160
160-
<180
180-
<200
200-
<220
>220
n
45
13
12
11
6

3
45
%
100
28,89
26,67
24,44
13,33
6,67
100











QRS giãn





n
41
04

21
09
75

54,67
5,33
28
12
100
538

60
40
100
 


gi           
 








n
42
3

45

92,33
7,67
100






<40
40<60
60-<80
>80

n
16
12
9
8
45

35,55
26,67
20
17,78
100

-60 (26,67%), nhóm

-




Nhóm 1
Nhóm 2
Nhóm 3
P (Anova) (>0,05)

51,1 + 8,4
51,3 + 8,1
51,2 + 7,9
0,99

13/2
12/3
14/1
0,98
            



Nhóm 1
Nhóm 2
Nhóm 3
p (Anova)
n/15
4/15
7/15

13/15
<0,001


26,67
46,67
86,67










 Verapamil --10
-
 Amiodarone 


539
Nhóm 3        
trong 2-- Amiodarone 

 








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 
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


- 

-  



1. 

-277.
2.  
-201.
3.               

-277.
4. 
-199.
5. Poole JE, Bardy GH. (2001), Further evidence supporting the concept of T-wave
memory:observation in patients having undergone high-energy direct current catheter
ablation of the Wolff-Parkinson-White syndrome, Eur Heart J, pp. 801-807.
6. Yeh SJ, Wang CC,Wen MS et al. (2003), Radiofrequency ablation in multiple accessory
pathways and thephysiologc implication, Am J, Cadiol, pp. 1174-1180.
7. Fananapazir L, German LD, Galagher JJ, et al. (2003), Importance of preexcited QRS
morphology during induced atrial fibrillation in the Wolff-Parkinson-White syndrom:
The importatance of the accessory pathway, Am Heart J. pp. 125:753.
8. Podric PJ, Kowey PR (2005), Cardiac arrhythmia: mechanisms, diagnosia and
agagement, Maryland: Williams - Wilkins, pp. 847-891.