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作 者:张文乐[1] 刘帅帅[1] 金莲花[1] 朴金花[1]
机构地区:[1]吉林大学第一医院小儿心血管科,吉林长春130021
出 处:《临床儿科杂志》2015年第4期348-351,共4页Journal of Clinical Pediatrics
摘 要:目的探讨儿童心动过速性心肌病(TIC)的临床特点、治疗及预后。方法回顾性分析自2007年1月至2014年10月住院治疗的20例TIC患儿的临床资料。结果 20例TIC患儿中,婴儿11例,幼儿1例,学龄前期5例、青春期3例。心律失常类型为房性心动过速15例(75%),各年龄段均有;阵发性室上性心动过速3例(15%),婴儿2例、青春期1例;室性心动过速2例(10%),均为婴儿。11例患儿给予抗心律失常药物治疗后恢复窦性心律,5例控制心室率,1例药物效果不佳最终行射频消融手术获得根治,另外3例患儿入院后即行射频消融。治疗后复查心脏超声左室射血分数(LVEF)及左室舒张末内径(LVDD),均较治疗前明显恢复,差异有统计学意义(P<0.01)。结论 TIC以婴儿期最常见,心律失常类型以房性心动过速为主;首选药物治疗,药物治疗无效者或年长儿可选择射频消融术。ObjectiveTo explore the clinical features, treatment, and outcomes of tachycardia induced cardiomy-opathy (TIC) in children.MethodsThe clinical data of 20 children with TIC hospitalized from January 2007 to October 2014 were retrospectively analyzed.ResultsIn 20 patients with TIC, there were 11 infants, one toddler, 5 pre-school age children, and 3 adolescent patients were as follows: 15 cases of atrial tachycardia (distributed in each age group), 3 cases of paroxysmal supraventricular tachycardia (2 in infancy and one in adolescence), and 2 cases of ventricular tachycardia (2 in infancy). After the treatment of anti-arrhythmic drugs, sinus rhythm was restored in 11 patients and ventricular rate was controlled in 5 patients while poor effect of drug was found in one patient who received radiofrequency ablation eventually and got cured. Three patients received radiofrequency ablation after admission immediately. Compared with those before treatment, left ventricular ejection fraction (LVEF) and left ventricular diastolic diameter (LVDD) measured by cardiac ultrasonography were signiifcantly improved after treatment (P〈0.01).ConclusionsTIC is common in infancy. Atrial tachycardia is the main type of arrhythmia. Generally drug therapy is the ifrst choice in the treatment of TIC but in older children and those refractory to drug therapy the radiofrequen-cy ablation is chosen.
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