临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (7): 488-.doi: 10.3969/j.issn.1000-3606.2017.07.003

• 心血管疾病专栏 • 上一篇    下一篇

儿童阵发性室上性心动过速67 例临床及治疗分析

张丽1, 李筠1, 肖婷婷1, 谢利剑1, 沈捷2   

  1. 1 . 上海市儿童医院 上海交通大学附属儿童医院心内科(上海 200062) 2 . 上海交通大学医学院附属上海儿童医学中心心内科( 上海 200127)
  • 收稿日期:2017-07-15 出版日期:2017-07-15 发布日期:2017-07-15
  • 通讯作者: 李筠 E-mail:liyun@shchildren.com.cn

Clinical features and treatment of paroxysmal supraventricular tachycardia in children

ZHANG Li1, LI Yun1, XIAO Tingting1, XIE Lijian1, SHEN Jie2   

  1. 1. Department of Cardiology, Children’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 200062, China; 2. Department of Cardiology, Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
  • Received:2017-07-15 Online:2017-07-15 Published:2017-07-15

摘要: 目的 探讨儿童阵发性室上性心动过速(PSVT)的临床特点及治疗。方法 回顾分析67例PSVT患儿的临床 资料,比较不同治疗的疗效。结果 小婴儿临床表现为面色苍白、气促、烦躁、汗多等;儿童表现为胸闷、心悸、腹部不适、 乏力等。将电复律、食管调搏、物理治疗、药物治疗的疗效进行比较,差异有统计学意义(P<0.05),治疗阵发性室上性心 动过速的转复率,以食管调博转复率最高,物理治疗转复率最低;普罗帕酮、地高辛、胺碘酮3种药物的转复率无明显差别。 结论 PSVT婴幼儿临床表现不典型,易被忽略。治疗PSVT方法多样,可先试行兴奋迷走神经,无效者再采用药物治疗, 也可以使用电复律和食管调搏术,其中食管调搏术复律成功率较高。治疗PSVT药物的疗效取决于多方面因素,选择药物 需要因人而异。

Abstract: Objective To explore the clinical characteristics and treatment of paroxysmal supraventricular tachycardia (PSVT) in children. Methods The clinical data of 67 children with PSVT were analyzed retrospectively, and the therapeutic effects of different treatments were compared. Results The clinical manifestations of infants were paleness, shortness of breath, irritability and sweating, and children showed chest tightness, palpitations, abdominal discomfort and fatigue. The curative effect of electric cardioversion, transesophageal atrial pacing, physical therapy, and drug therapy was statistically different (P<0.05),  The different cardioversion rates of them were observed for the treatment of paroxysmal supraventricular tachycardia. The cardioversion rate of transesophageal atrial pacing, was the highest, and the rate of physical therapy was the lowest. There was no significant difference in the cardioversion rate between propafenone, digoxin and amiodarone. Conclusion The clinical manifestations of PSVT in infants are atypical and easily to be ignored. There are many methods for treatment of PSVT. The vagus nerve can be stimulated first, and, if no response, either drugs or electric cardioversion and transesophageal atrial pacing can be used. The cardioversion rate of transesophageal atrial pacing is higher. The drug effectiveness for the treatment of PSVT depends on many factors, and our choice of medication varies from person to person.