新生儿非良性快速型心律失常临床特点与疗效观察  

Clinical features and treatment of non-benign tachyarrhythmia in newborn

作　　者：卢庆晖[1] 彭爱霞[1] 阳红华[1] 张志刚[1] 夏晓芹[1] Lu Qinghui Peng Aixia Yang Honghua Zhang Zhigang Xia Xiaoqin(Tungwah Hospital Affiliated to Sun Yat-sen University, Dongguan 523113, China （Lu QH, Peng AX, Yang HH, Zhang ZG ,Xia XQ)

机构地区：[1]中山大学附属东华医院东莞东华医院,东莞523113

出　　处：《中国小儿急救医学》2016年第10期690-693,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的：探讨新生儿非良性快速型心律失常的临床特点与疗效观察。方法回顾性分析2007年至2014年我院NICU住院的非良性快速型心律失常患儿的临床资料。观察比较新生儿非良性快速型心律失常的发生特点，药物及直流电复律等方法的治疗效果、并发症等。结果非良性快速型心律失常新生儿共13例，其中男10例，女3例；足月儿8例，早产儿4例，过期产儿1例；室性心动过速8例，室上性心动过速5例；原发疾病：重度窒息、败血症、肺炎、上呼吸道感染、心肌炎、呼吸窘迫综合征及先天性心脏病等。其中9例（69.2％）由其他心律失常用药后转化而来。所有病例均使用了抗心律失常药物，10例（76.9％）联合使用了直流电复律治疗。13例中12例治疗有效（92.3％）。复律后短期复发或并发其他严重心律失常8例（61.5％），均使用了乙胺碘伏酮，其中4例治愈。室性心动过速患儿均有严重原发病及诱因，病死率50％（4/8）；室上性心动过速患儿无一例死亡。结论非良性快速型心律失常可发生在新生儿各年龄段及各胎龄，其中室上性心动过速预后较好，室性心动过速预后差；运用直流电复律加抗心律失常药是治疗新生儿快速型心律失常的有效方法，抗心律失常药乙胺碘伏酮可能是较好的一种药物选择。Objective To discuss the clinical features and treatment of non-benign tachyarrhythmia in newborn. Methods The clinical data of non-benign tachyarrhythmia infants hospitalized in our NICU from 2007 to 2014 were analyzed retrospectively. The clinical features,the effect of drug and direct current cardioversion were observed and analyzed. Results Among 13 infants with non-benign tachyarrhythmia,10 cases were male and 3 cases were female. Eight cases were term infants,4 cases were preterm infants and 1 case was postterm infant. Eight cases were ventricular tachycardia,and 5 cases were supraventricular tachycar-dia. The protopathy diseases were asphyxia,sepsis,pneumonia,acute upper respiratory infections,myocardi-tis,neonatal respiratory distress syndrome,congenital heart disease and so on. Nine of 13 cases were trans-formed from other arrhythmia after they were given anti-arrhythmic drugs. Ten cases （76. 9%） needed direct electric cardioversion,and the effective rate was 92. 3%. Eight cases （61. 5%） recurred or transformed to other severe arrhythmia in short-term,and all of these cases were given amiodarone,and 4 cases were cured. All ventricular tachycardic infants had severe protopathy diseases and causes,and the mortality rate was 50%（4/8）. No death in children with supraventricular tachycardia. Conclusion Non-benign arrhythmias are the common types of arrhythmia in the NICU. Patients with supraventricular tachycardia have good prognosis,but others with ventricular tachycardia have bad one. Direct electric cardioversion combined with anti-arrhythmic drugs is the effective treatment,and probably amiodarone is the better choice of anti-arrhythmic drugs.

关 键 词：心律失常 临床分析 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]