重症肺炎患儿心律失常相关因素分析及处理  

Related factors of arrhythmia in children with severe pneumonia and its preventive methods

作　　者：刘亚秋[1] 刘喜[1] 李凯红[1] 丘喜琴[1] 

机构地区：[1]广东省深圳市宝安区妇幼保健院,广东深圳518133

出　　处：《儿科药学杂志》2007年第6期24-25,49,共3页Journal of Pediatric Pharmacy

摘　　要：目的:探讨重症肺炎患儿心律失常发生的原因及治疗对策。方法:调查深圳市宝安区妇幼保健院儿科重症监护病房(PICU)2004年1月至2006年12月共收治临床资料完整的重症肺炎患儿90例,对患儿临床特征与心律失常的关系进行单因素方差分析。结果:90例中有42例重症肺炎患儿出现心律失常56例次,发生率46.7%(42/90),其中,窦性心动过缓3例,频发房性早搏10例,房性心动过速5例,室上性心动过速3例,心房颤动2例,室性早搏8例,室性心动过速2例,室性早搏伴短阵室速2例,一度房室传导阻滞4例,二度房室传导阻滞2例,一度房室传导阻滞伴室性早搏1例。低年龄(χ2=11.43,P=0.000)、Ⅰ型呼吸衰竭(χ2=7.23,P=0.007)、心功能不全(χ2=19.44,P=0.000)、肌钙蛋白升高(χ2=16.99,P=0.000)及低血钾(χ2=19.74,P=0.000)是重症肺炎心律失常影响因素。结论:心律失常是重症肺炎患儿早期较严重并发症,低年龄、Ⅰ型呼吸衰竭、心功能不全、心肌损害程度及低血钾等与重症肺炎患儿心律失常有密切关系,及时有效的氧疗,及早纠正心功能不全,控制感染,保护心肌治疗,维持内环境稳定,防止电解质紊乱和缺氧、酸中毒的发生,是防止重症肺炎患儿心律失常的有效措施。Objective： To investigate the related factors of arrhythmias in children with severe pneumonia and its preventive methods, Methods： All clinical data of 90 eases with severe pneumonia from Jan. 2004 to Dee 2006 were reviewed. Results： 56 arrhythmias occurred in 42 patients （46.7 % ）, including premature complexes, supraventrieular taehyeardia, atrial fibrillation, Sinus bradyeardia, Ⅰ° and Ⅱ ° AVB et al. Being young, eardiopulmonary insufficiency, myocardieal damage and hypokalemia were the related factors of arrhythmias in children with severe pneumonia （P 〈 0.01）. Conclusions： Arrhythmia was a severe early complication in children with severe pneumonia. Early and effective oxygen therapy, myocardial protection, infection control, maintaining of normal circulation, and prevention of electrolytes and anoxia/aeidosis may be the most effective methods to prevent children with severe pneumonia from arrhythmias.

关 键 词：重症肺炎 心律失常 危险因素 儿童 

分 类 号：R725.631[医药卫生—儿科] R541.7[医药卫生—临床医学]