起搏器联合伊布利特治疗儿童慢-快综合征1例并文献复习  

Pacemaker Combined with Ibutilide in the Treatment of a Child with Bradycardia-Tachycardia Syndrome and Literature Review

作　　者：周挥茗 李运泉[1] 巴宏军[1] 李轩狄[1] 王慧深[1] 覃有振[1] Zhou Huiming;Li Yunquan;Ba Hongjun;Li Xuandi;Wang Huishen;Qin Youzhen(The First Affiliated Hospital,Sun Yat-sen University,Guangdong Guangzhou 510080,China)

机构地区：[1]中山大学附属第一医院,广东广州510080

出　　处：《儿科药学杂志》2021年第6期11-13,共3页Journal of Pediatric Pharmacy

基　　金：教育部博士点—博导基金,编号20130171110048。

摘　　要：目的:分析1例双腔永久起搏器(DDD起搏模式)联合伊布利特治疗儿童慢-快综合征的病例,探讨伊布利特在儿童应用的有效性和安全性。方法:诊治1例儿童慢-快综合征,结合病例特点与文献资料,总结分析起搏器联合伊布利特治疗儿童慢-快综合征的有效性和安全性。结果:置入起搏器后,患儿的心动过缓得以纠正,存在房内折返性心动过速、QT-c间期延长。伊布利特使患儿房内折返性心动过速消失,但QT-c间期进一步延长。伊布利特继续支持治疗1个月后,房内折返性心动过速复现,QT-c间期明显缩短;3个月后,房内折返性心动过速仍存在,但QT-c间期已缩短至正常范围。结论:双腔永久起搏器(DDD起搏模式)是治疗儿童病态窦房结综合征的有效手段,伊布利特对长期性儿童慢-快综合征的快速性心律失常有短期抑制作用。伊布利特治疗后长期支持治疗和随访非常重要。Objective:To analyze the efficacy of dual-chamber permanent pacemaker(DDD pacing mode)combined with ibutilide in the treatment of a child with bradycardia-tachycardia syndrome,and explore the application availability and security of ibutilide in children.Methods:The efficacy and safety of pacemaker combined with ibutilide in the treatment of a child with bradycardia-tachycardia syndrome were summarized and analyzed based on the characteristics of the case and literature.Results:After pacemaker implantation,the bradycardia of the child was corrected,and there was intra atrial reentrant tachycardia and prolonged QT-c interval.Ibutilide resulted in the disappearance of intra atrial reentrant tachycardia in the child,but the QT-c interval was further prolonged.After one month of continued supportive therapy with ibutilide,the intra atrial reentrant tachycardia recurred and QT-c interval was significantly shortened.After three months,there was still some intra atrial reentrant tachycardia,yet the QT-c interval had been shortened to the normal range.Conclusion:Dual-Chamber permanent pacemaker(DDD pacing mode)is an effective method for the treatment of sick sinus syndrome in children.Ibutilide has the short-term inhibitory effect on the tachyarrhythmia of bradycardia-tachycardia syndrome in children.Long-Term supportive treatment and follow-up after ibutilide treatment is essential.

关 键 词：起搏器 伊布利特 儿童 慢-快综合征 

分 类 号：R725.4[医药卫生—儿科]