临时起搏器治疗儿童暴发性心肌炎的临床分析  

Clinical Analysis of Temporary Pacemaker in the Treatment of Fulminant Myocarditis in Children

作　　者：李亭亭[1] 程佶[1] LI Ting-ting(CHENG Ji Department of Cardiology,Tianjin Children’s Hospital/Tianjin University Children’s Hospital,Tianjin 300074)

机构地区：[1]天津市儿童医院/天津大学儿童医院心脏中心,天津300074

出　　处：《中国医疗器械信息》2023年第16期35-37,50,共4页China Medical Device Information

摘　　要：目的:探讨临时起搏器在儿童暴发性心肌炎中的临床应用。方法:回顾性分析天津市儿童医院2017年10月~2020年9月植入临时起搏器的暴发性心肌炎患儿的临床资料。结果:共8例暴发性心肌炎患儿植入临时起搏器,男2例,女6例,平均年龄(100.3±45.6)个月。入院至植入临时起搏器中位时间2.8h,安装时间(54.4±20.7)min。均为心内膜起搏,VVI起搏模式,初始感知电压1~2mV,输出电压5V,起搏频率70~85次/min。7例患儿在(22.4±19.1)h恢复窦性心律,临时起搏器应用时间(165.1±32.7)h,1例未恢复。2例患儿出现起搏功能不良,1例发生导管移位。7例患儿成功摘除临时起搏器并好转出院,随访(22.4±12.2)个月未再出现心律失常,心功能正常;1例放弃治疗且失访。结论:临时起搏器具有操作简单、安全有效的特点,对于儿童暴发性心肌炎的成功救治和改善预后有重要的作用。Objective:To explore the clinical application of temporary pacemaker in children with fulminant myocarditis.Methods:The clinical data of children with fulminant myocarditis who were treated with temporary pacemakers in Tianjin Children’s Hospital from October 2017 to September 2020 were analyzed retrospectively.Results:8 children with fulminant myocarditis treated with temporary pacemakers were included in this study,including 2 males and 6 females,the mean age(100.3±45.6)months.The median time from admission to implantation of the temporary pacemakers was 2.8h and operation time was(54.4±20.7)min.All 8 children were implanted with temporary endocardial pacemakers.The pacing mode was VVI.The initial perceptual voltage was 1-2mV,the output voltage was 5V,and the pacing frequency was 70-85 beats/min.7 children reverted to sinus rhythm in(22.4±19.1)hours and the working time of temporary pacemakers was(165.1±32.7)hours.1 child did not revert to sinus rhythm.There were poor pacing in 2 children and catheter displacement in 1 child during pacing.7 children who were removed temporary pacemakers successfully and discharged from hospital were followed up for(22.4±12.2)months.During the follow-up period,the cardiac functions were basically normal and no new arrhythmia appeared.1 child gave up treatment and lost follow-up.Conclusion:Temporary pacemaker has the advantage of simple operation,definite effect and safety,which plays an important role in the successful rescue and improvement of prognosis of children with fulminant myocarditis.

关 键 词：临时起搏器 暴发性心肌炎 儿童 心律失常 

分 类 号：R459.7[医药卫生—急诊医学]