儿童心力衰竭的诊断与治疗进展  

Progress in diagnosis and treatment of heart failure in children

作　　者：钱明阳[1] 洪钿 Qian Mingyang;Hong Dian(Department of Pediatric Cardiology,Guangdong Cardiovascular Institute,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510000,China)

机构地区：[1]广东省心血管病研究所,广东省人民医院,广东省医学科学院心儿科,广州510000

出　　处：《中华实用儿科临床杂志》2020年第1期14-18,共5页Chinese Journal of Applied Clinical Pediatrics

摘　　要：心力衰竭是心脏失去有效泵血或接纳足量静脉回流功能的复杂的临床综合征,从而引起一系列症状,在儿童中的临床表现因年龄而不同。儿童心力衰竭的原因主要是先天性心脏病和心肌病。药物应用在儿童心力衰竭中的治疗进展迅猛,沙库巴曲/缬沙坦于2019年10月由美国食品药品监督管理局(FDA)批准其用于≥1岁儿童伴有症状性左心室收缩功能障碍,标志着儿童心力衰竭药物治疗的新起点。植入型心律转复除颤器和心脏再同步化治疗适用于部分具有指征的患者。机械循环支持是心肺衰竭患者不可缺失的治疗手段,包括体外膜肺氧合和心室辅助装置,作为短期循环辅助-移植等待的重要过渡。儿童心脏移植是心力衰竭终末的治疗方案。Heart failure is a complex clinical syndrome characterized by the heart losing the function of effective blood-pumping and venous return,which will cause a series of symptoms,and its clinical manifestations vary with the age of children.The main causes of heart failure in children are congenital heart disease and cardiomyopathy.Drug therapy for heart failure in children has gained rapid progression recently with Sacubitril/valsartan being a typical one,which was approved by Food and Drug Administration(FDA)in October 2019 for its effective use in symptomatic left ventricular dysfunction in children aged 1 year and above,marking that the drug therapy for heart failure in children stands at a new starting point.Implantable cardioverter defibrillator and cardiac resynchronization therapy are applicable to some patients with indications.Mechanical circulatory support is essential in the treatment of patients with cardiopulmonary failure,including extracorporeal membrane oxygenation and ventricular assist device,which is used as an important transition of short-term circulatory assisted transplantation.Pediatric heart transplantation is a treatment option for end-stage heart failure.

关 键 词：心力衰竭 先天性心脏病 儿童重症监护 进展 

分 类 号：R72[医药卫生—儿科]