1例疑似心肌炎的儿童扩张型心肌病外科诊治报告  

Surgical diagnosis and treatment of children dilated cardiomyopathy suspected of myocarditis:a case report

作　　者：童路 彭华 李平[1] 董念国[1] 史嘉玮[1] TONG Lu;PENG Hua;LI Ping;DONG Nian-guo;SHI Jia-wei(Department of Cardiovascular Surger,Union Hospital,Tongji Medical College,Huazhong University of Science cmd Technology,Wuhan 430022,China;Department of Pediatrics,Union Hospital,Tongji Medical College,Huazhong University of Science cmd Technology,Wuhan 430022,China)

机构地区：[1]华中科技大学同济医学院附属协和医院心外科,湖北省武汉市430022 [2]华中科技大学同济医学院附属协和医院儿科,湖北省武汉市430022

出　　处：《中国心血管病研究》2020年第2期189-192,共4页Chinese Journal of Cardiovascular Research

基　　金：国家自然科学基金面上项目(81770387)。

摘　　要：目的报告1例疑似心肌炎的儿童扩张型心肌病(dilated cardiomyopathy,DCM)在体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)辅助下成功原位心脏移植的案例并分享诊治经验.方法对2019年武汉协和医院心外科收治的1例诊断为DCM在ECMO辅助下行原位心脏移植的患儿的临床资料进行分析,查阅文献分析病因诊断及诊治经过.结果7岁儿童因"咳嗽21天,加重伴心慌、呼吸困难10天",由外院带ECMO和气管插管转入我院.患儿内科药物治疗及ECMO辅助14天后心功能仍差,结合病史、诊治经过及检查资料考虑DCM,行原位心脏移植后顺利撤除ECMO,术后心肌病检结果支持诊断.结论病因诊断对治疗策略的选择至关重要.目前国内儿童DCM以心脏移植为主要治疗手段.Objective A case of dilated cardiomyopathy(DCM)suspected of myocarditis undergoing orthotopic heart transplantation assisted by ECMO was reported and the experience in diagnosis and treatment was shared.Methods To analyze the clinical data of a child with DCM who underwent orthotopic heart transplantation assisted by ECMO in the Department of cardiac surgery of Wuhan Union Medical College Hospital in 2019 and consult the literature to probe the etiology,diagnosis and treatment.Results A seven-year-old child was transferred to our hospital with ECMO and tracheal intubation because of"cough for 21 days,aggravation of palpitation and dyspnea for 10 days".After 14 days of medical treatment and ECMO assistance,the cardiac function was still poor.DCM was considered in combination with medical history,treatment and examination data.ECMO was successfully removed after orthotopic heart transplantation.Postoperative cardiomyopathy results supported the diagnosis.Conclusion Etiological diagnosis is crucial to the choice of treatment strategies.At present,heart transplantation is the main treatment for children DCM in China.

关 键 词：儿童扩张型心肌病 心肌炎 儿童心脏移植 

分 类 号：R542.2[医药卫生—心血管疾病]