婴儿心房扑动治疗及随访分析

发布时间：2018-06-10 18:54

本文选题：心房扑动 + 治疗　；参考：《临床儿科杂志》2017年02期

【摘要】：目的探讨婴儿心房扑动(房扑)的临床治疗转归及预后。方法回顾分析2009年3月至2015年9月收治的34例婴儿期房扑患者的临床资料,比较不同类型房扑药物治疗效果。结果 34例患儿中,单纯型房扑24例,复杂型房扑10例。药物治疗总复律率为70.6%(24/34);24例单纯型房扑患儿中21例(87.5%)复律,10例复杂型房扑患儿中3例(30.0%)复律,两组差异有统计学意义(P=0.003)。单用洋地黄治疗,24例单纯型房扑患儿中11例(45.8%)复律,8例复杂型房扑患儿中1例(12.5%)复律,两组差异无统计学意义(P=0.206);联合用药治疗,13例单纯型房扑患儿中10例(76.9%)复律,9例复杂型房扑患儿中2例(22.2%)复律,两组差异有统计学意义(P=0.036)。经药物治疗,14例新生儿房扑患者中12例(85.7%)复律,20例非新生儿患者中12例(60.0%)复律,两组差异无统计学意义(P=0.216)。10例复杂型房扑患儿中,2例有心衰症状者使用同步电复律,1例恢复窦性心律后未复发,1例多次电复律后仍有房扑反复发作,出现心源性休克后死亡。3例单纯型房扑、6例复杂型房扑患儿治疗后仍有短阵房扑及房速发作,出院后予以地高辛及普罗帕酮口服治疗。结论单纯型婴儿房扑预后良好,无需长期抗心律失常药物治疗;复杂型婴儿房扑常规药物治疗效果不佳,房扑复发率高。
[Abstract]:Objective to investigate the outcome and prognosis of atrial flutter (AF) in infants. Methods the clinical data of 34 cases of infantile flutter from March 2009 to September 2015 were analyzed retrospectively. Results among 34 cases, 24 cases were simple type atrial flutter and 10 cases complicated type atrial flutter. The total repetition rate of drug therapy was 70.6 / 24 / 34 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 / 24 respectively. Among 24 cases of simple atrial flutter treated with digitalis alone, 11 cases (45.8 cases) were treated with digitalis alone, and 1 case (12.5%) of 8 cases of complex atrial flutter was treated with digitalis. There was no significant difference between the two groups (P < 0. 206), and there was a significant difference between the two groups in the treatment of 10 cases of simple atrial flutter (10 cases, 76. 9%) and 9 cases of complex type of atrial flutter (2 cases, 22. 2). The difference between the two groups was statistically significant (P < 0. 036). 12 out of 14 neonatal atrial flutter patients (85.7) and 12 out of 20 non-neonatal patients (60. 0%) were treated with drugs. There was no significant difference between the two groups. In 10 children with complicated atrial flutter, 2 patients with heart failure symptoms were treated with synchronous electrocardioversion, 1 patient had no recurrence after recovery of sinus rhythm, 1 patient still had recurrent atrial flutter after repeated electrocardioversion. Three patients died after cardiogenic shock. 6 children with complex atrial flutter still had short atrial flutter and atrial tachycardia after treatment. After discharge, they were treated with digoxin and propafenone orally. Conclusion simple infantile atrial flutter has a good prognosis and no long-term antiarrhythmic drug therapy, and complex infantile atrial flutter routine therapy is not effective, and the recurrence rate of atrial flutter is high.
【作者单位】：湖南省儿童医院心血管内科;
【分类号】：R725.4

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