高压氧综合疗法对小儿病毒性心肌炎的疗效及其影响因素分析  

Analysis on the clinical efficacy of combined hyperbaric oxygen therapy in treating children with viral myocarditis and its influencing factors

作　　者：刘晓栋[1] 郭晓涛[2] 张学志 Liu Xiaodong;Guo Xiaotao;Zhang Xuezhi(Department of Pre-hospital First Aid Station,Children’s Hospital of Shanxi,Taiyuan 030013,China)

机构地区：[1]山西省儿童医院院前急救站,太原030013 [2]山西省儿童医院神经内科,太原030013 [3]山西省儿童医院康复科,太原030013

出　　处：《中华航海医学与高气压医学杂志》2021年第6期772-775,共4页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

基　　金：山西省自然科学基金(2011011043-3)。

摘　　要：目的观察高压氧综合疗法对小儿病毒性心肌炎(VMC)的治疗效果,分析患儿治疗无效的影响因素。方法选取2019年1月至2020年9月山西省儿童医院收治的68例VMC患儿,均接受常规治疗和高压氧综合疗法治疗,根据疗效分为有效组(n=52)与无效组(n=16)。比较2组患儿的一般资料、心电图、左心室射血分数(LVEF)、白细胞(WBC)计数、C-反应蛋白(CRP)和心肌肌钙蛋白I(cTnI)水平。结果有效组与无效组患儿QRS波时限延长、快速性心律失常、LVEF、CRP及cTnI水平对比,差异有统计学意义(P<0.05)。经多因素Logistic回归分析,QRS波时限延长、快速性心律失常、LVEF值低、CRP和cTnI过表达均是高压氧综合疗法治疗VMC患儿无效的影响因素(OR>1.000,P<0.05)。结论高压氧综合疗法治疗VMC患儿无效可能与QRS波时限延长、快速性心律失常、LVEF值低等因素有关,临床应重视伴有上述因素的VMC患儿的早期评估及合理干预,以提高治疗效果。Objective To observe the clinical efficacy of combined hyperbaric oxygen(HBO)therapy in treating children with viral myocarditis(VMC),and to analyze the influencing factors of ineffective treatment.Methods A total of 68 children with VMC admitted to the Children’s Hospital of Shanxi from January 2019 to September 2020 were selected and treated with conventional therapy and combined HBO therapy.Based on the clinical efficacy,they were divided into effective group(n=52)and ineffective group(n=16).The demographic data,electrocardiography(ECG),left ventricular ejection fraction(LVEF),C-reactive protein(CRP),white blood cell(WBC)count,and cardiac troponin I(cTnI)of children in the two groups were compared.The influencing factors of ineffective combined HBO therapy in children with VMC were found out by univariate and multivariate analysis.Results There were statistically significant differences in the comparison of prolonged QRS duration,tachyarrhythmia,and the levels of LVEF,CRP,and cTnI between the two groups(P<0.05).The prolonged QRS duration,tachyarrhythmia,low LVEF,and the overexpression of CRP and cTnI were the influencing factors of ineffective treatment of combined HBO therapy in children with VMC(OR>1,P<0.05).Conclusion The failure of combined HBO therapy in children with VMC may be related to the prolonged QRS duration,tachyarrhythmia,low LVEF,and other factors.In clinical practice,more attention should be paid to the early evaluation of VMC children with the above factors and reasonable interventions should also be applied,which is of positive significance to improve the clinical efficacy.

关 键 词：病毒性心肌炎 高压氧 左心室射血分数 C-反应蛋白 心肌肌钙蛋白I 

分 类 号：R725.4[医药卫生—儿科]