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JAHA:胸硬膜外麻醉对室性心动过速的短期治疗有效!

2017-10-28 xing.T MedSci原创

在这个VT风暴系列病例中有半数以上患者对TEA有很好的反应。对于VT风暴患者采用TEA治疗可能有效,并且应该被认为是VT风暴患者的一种治疗选择,尤其是持续性VT患者,这些患者对最初治疗无效。深镇静可以改善VT的负担提示交感兴奋性在持续性VT和预测对TEA反应较好的个体中起着关键的作用。

旨在调节自主神经系统的新疗法,包括胸硬膜外麻醉(TEA),在系列病例中已被证实有利于难治性室性心动过速(VT)风暴的治疗。然而,目前尚不清楚这些治疗选项何时可以被考虑使用。近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员回顾了采用TEA治疗VT风暴的多中心经验,以确定其最佳治疗用途。

研究人员对在2005年7月至2016年3月期间发生VT风暴的11例患者进行回顾性分析,以确定其临床特征、结局和治疗效果。

研究人员发现临床表现为持续性VT的患者有7例(64%),其中多形性VT患者有3例(27%)和单形性VT患者有8例(73%)。潜在疾病包含非缺血性心肌病5例(45%),缺血性心肌病3例(27%)以及肥厚型心肌病、Brugada综合征和心脏脂肪瘤各1例(9%)。5例(45%)患者对TEA反应很好,1例(9%)患者对TEA只有部分反应,4例反应很好的应答者为持续性VT。所有4例患者记录了对深镇静有反应的患者表现出对TEA反应很好。

在这个VT风暴系列病例中有半数以上患者对TEA有很好的反应。对于VT风暴患者采用TEA治疗可能有效,并且应该被认为是VT风暴患者的一种治疗选择,尤其是持续性VT患者,这些患者对最初治疗无效。深镇静可以改善VT的负担提示交感兴奋性在持续性VT和预测对TEA反应较好的个体中起着关键的作用。

原始出处:


Duc H. Do,et al. Thoracic Epidural Anesthesia Can Be Effective for the Short‐Term Management of Ventricular Tachycardia Storm.JAHA.2017. https://doi.org/10.1161/JAHA.117.007080

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    2017-10-30 zhaohui6731
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    2017-10-29 Y—xianghai

    学习了新知识

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=2027255, encodeId=c8f3202e25580, content=<a href='/topic/show?id=5259e36453f' target=_blank style='color:#2F92EE;'>#硬膜外麻醉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73645, encryptionId=5259e36453f, topicName=硬膜外麻醉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0357291, createdName=xiaoshitou, createdTime=Fri Feb 16 13:04:00 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937131, encodeId=f358193e131da, content=<a href='/topic/show?id=c06ae363256' target=_blank style='color:#2F92EE;'>#硬膜外#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73632, encryptionId=c06ae363256, topicName=硬膜外)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Mar 28 21:04:00 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267580, encodeId=2f60126e580d8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407854, encodeId=c901140e8540e, content=<a href='/topic/show?id=75f34622831' target=_blank style='color:#2F92EE;'>#室性心动过速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46228, encryptionId=75f34622831, topicName=室性心动过速)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19932732764, createdName=kalseyzl, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471107, encodeId=594414e110749, content=<a href='/topic/show?id=f06c5090466' target=_blank style='color:#2F92EE;'>#心动过速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50904, encryptionId=f06c5090466, topicName=心动过速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35817104001, createdName=fengyi814, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256800, encodeId=bbf1256800f4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sun Oct 29 00:26:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256716, encodeId=875a256e1653, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sat Oct 28 17:04:16 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256690, encodeId=15b525669056, content=室性心动过速治疗新方法., beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Oct 28 14:56:57 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256675, encodeId=85642566e58d, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Oct 28 13:59:07 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-28 Y—xianghai

    学习了新知识

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2027255, encodeId=c8f3202e25580, content=<a href='/topic/show?id=5259e36453f' target=_blank style='color:#2F92EE;'>#硬膜外麻醉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73645, encryptionId=5259e36453f, topicName=硬膜外麻醉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0357291, createdName=xiaoshitou, createdTime=Fri Feb 16 13:04:00 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937131, encodeId=f358193e131da, content=<a href='/topic/show?id=c06ae363256' target=_blank style='color:#2F92EE;'>#硬膜外#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73632, encryptionId=c06ae363256, topicName=硬膜外)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Mar 28 21:04:00 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267580, encodeId=2f60126e580d8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407854, encodeId=c901140e8540e, content=<a href='/topic/show?id=75f34622831' target=_blank style='color:#2F92EE;'>#室性心动过速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46228, encryptionId=75f34622831, topicName=室性心动过速)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19932732764, createdName=kalseyzl, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471107, encodeId=594414e110749, content=<a href='/topic/show?id=f06c5090466' target=_blank style='color:#2F92EE;'>#心动过速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50904, encryptionId=f06c5090466, topicName=心动过速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35817104001, createdName=fengyi814, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256800, encodeId=bbf1256800f4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sun Oct 29 00:26:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256716, encodeId=875a256e1653, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sat Oct 28 17:04:16 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256690, encodeId=15b525669056, content=室性心动过速治疗新方法., beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Oct 28 14:56:57 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256675, encodeId=85642566e58d, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Oct 28 13:59:07 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-28 1e0f8808m18(暂无匿称)

    室性心动过速治疗新方法.

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2027255, encodeId=c8f3202e25580, content=<a href='/topic/show?id=5259e36453f' target=_blank style='color:#2F92EE;'>#硬膜外麻醉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73645, encryptionId=5259e36453f, topicName=硬膜外麻醉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0357291, createdName=xiaoshitou, createdTime=Fri Feb 16 13:04:00 CST 2018, time=2018-02-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1937131, encodeId=f358193e131da, content=<a href='/topic/show?id=c06ae363256' target=_blank style='color:#2F92EE;'>#硬膜外#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73632, encryptionId=c06ae363256, topicName=硬膜外)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Mar 28 21:04:00 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267580, encodeId=2f60126e580d8, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407854, encodeId=c901140e8540e, content=<a href='/topic/show?id=75f34622831' target=_blank style='color:#2F92EE;'>#室性心动过速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=46228, encryptionId=75f34622831, topicName=室性心动过速)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=19932732764, createdName=kalseyzl, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1471107, encodeId=594414e110749, content=<a href='/topic/show?id=f06c5090466' target=_blank style='color:#2F92EE;'>#心动过速#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=50904, encryptionId=f06c5090466, topicName=心动过速)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35817104001, createdName=fengyi814, createdTime=Mon Oct 30 04:04:00 CST 2017, time=2017-10-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256800, encodeId=bbf1256800f4, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sun Oct 29 00:26:00 CST 2017, time=2017-10-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256716, encodeId=875a256e1653, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sat Oct 28 17:04:16 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256690, encodeId=15b525669056, content=室性心动过速治疗新方法., beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Sat Oct 28 14:56:57 CST 2017, time=2017-10-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=256675, encodeId=85642566e58d, content=很好的文章.谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Oct 28 13:59:07 CST 2017, time=2017-10-28, status=1, ipAttribution=)]
    2017-10-28 清风拂面

    很好的文章.谢谢分享

    0

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