新生儿阵发性室上性心动过速临床特点及急诊处理  

Clinical characteristics and emergency treatment of infant PSVT

作　　者：刘万红[1] 王健怡[1] 李敏[1] 庄晓岚[1] 杜洪蓉[1] 

机构地区：[1]上海交通大学附属儿童医院

出　　处：《中国新生儿科杂志》2006年第1期9-11,共3页Chinese Journal of Neonatology

摘　　要：目的探讨新生儿阵发性室上性心动过速(PSVT)的临床特点、急诊处理方法并总结成功治疗经验。方法回顾本院21例新生儿PSVT的一般资料、临床特点、心电图表现、转复治疗方法、随访结果和预后进行分析。结果新生儿PSVT临床主要表现为面色苍白、神萎、拒奶、紫绀、心率大于210次／min,经心电图确诊为PSVT,5例合并预激综合征。4例通过兴奋迷走神经转复成功,11例药物转复成功,6例经上述方法无效后予食道心房调搏进行超速抑制转复成功。所有病例转复后都予地高辛加心得安维持治疗3-6个月。随访2年治愈20例,仅1例复发。结论新生儿PSVT往往无特异性临床表现与年长儿不同,诊断主要依赖体表心电图,部分合并预激综合征。转复治疗中兴奋迷走神经和药物转复均有一定疗效,但食道心房调搏更为迅速有效、安全、可重复且无副作用,值得临床推广应用。新生儿PSVT预后好。Objective To investigate the clinical characteristics and emergency treatment of infant PSVT. Methods The manifestations , whose EKG results, treatment, outcomes of 21 PSVT were analyzed. Results Manifestations of PSVT in 21 infants, included difficult feeding, pallor, HR 〉 210/min, weak heart sound, poor perfusion, whose EKG showed PSVT,ventricular rate 〉 180/min, P wave presentand nomal, P-R regular. After converted to a normal sinus rhythm, 5 cases were diagnosed as W-P-W syndom （3 cases were type A, 2 cases were type B）. Two cases combined with congenital heart disease. Four cases were converted by Valsalva maneuver 11 cases were converfed by drug ,6 cases were converted by transesophagial atrial pacing （TEAP）. All cases were taken Digoxin and Propranolol for 3 - 6 months. Later, 2 years 20 cases were cure, 1 case appeared PSVT again. Conclusions PSVT attack in infant has no specific manifestation, and it is different from children. PSVT can be digonosed by EKG. Part of PSTV are P-W syndome. Valsalva maneuver and drugs are effective method to convert, but TEAP is prefered, infant PSVT has a good prognosis.

关 键 词：新生儿 阵发性室上性心动过速 

分 类 号：R722.1[医药卫生—儿科]