摘要
目的探讨婴儿心房扑动(房扑)的临床治疗转归及预后。方法回顾分析2009年3月至2015年9月收治的34例婴儿期房扑患者的临床资料,比较不同类型房扑药物治疗效果。结果 34例患儿中,单纯型房扑24例,复杂型房扑10例。药物治疗总复律率为70.6%(24/34);24例单纯型房扑患儿中21例(87.5%)复律,10例复杂型房扑患儿中3例(30.0%)复律,两组差异有统计学意义(P=0.003)。单用洋地黄治疗,24例单纯型房扑患儿中11例(45.8%)复律,8例复杂型房扑患儿中1例(12.5%)复律,两组差异无统计学意义(P=0.206);联合用药治疗,13例单纯型房扑患儿中10例(76.9%)复律,9例复杂型房扑患儿中2例(22.2%)复律,两组差异有统计学意义(P=0.036)。经药物治疗,14例新生儿房扑患者中12例(85.7%)复律,20例非新生儿患者中12例(60.0%)复律,两组差异无统计学意义(P=0.216)。10例复杂型房扑患儿中,2例有心衰症状者使用同步电复律,1例恢复窦性心律后未复发,1例多次电复律后仍有房扑反复发作,出现心源性休克后死亡。3例单纯型房扑、6例复杂型房扑患儿治疗后仍有短阵房扑及房速发作,出院后予以地高辛及普罗帕酮口服治疗。结论单纯型婴儿房扑预后良好,无需长期抗心律失常药物治疗;复杂型婴儿房扑常规药物治疗效果不佳,房扑复发率高。
Objectives To assess treatment outcomes and prognosis in infants with atrial flutter (AFL). Methods Thirty-four (34) cases of infants with AFL in Hunan Children’s Hospital had been analyzed for clinical features, treatment outcomes and followup between March, 2009 and September, 2015. Based on ECG characteristics, the patients had been divided into simple and complex AFL groups. Based on age, they had been divided into neonates and non-neonates group. The aim of this study is to compare the clinical effects of drug treatment in different types of AFL. Results With digitalis alone, the cardioversion rate was 37.5%,nosignificant difference was observed between simple and complex AFL groups (45.8% vs 12.5%, P=0.206). Combining with otherdrugs, the cardioversion rate was 54.5%, which showed significant difference between simple and complex AFL groups (76.9% vs22.2%,P=0.036). The overall cardioversion rate was 70.6%, which showed significant difference between simple and complex AFLgroups(87.5% vs 30%, P=0.003). There was no significant difference in pharmaceutical cardioversion rate between neonates andnon-neonates group (85.7% vs 60.0%, P=0.216). Two cases with symptoms of heart failure used synchronized cardioversion. Onepatient restored to sinus rhythm, and another case was still recurrent of AFL after repeated electrical cardioversion, and eventuallydied of cardiogenic shock. After treatment, 9 patients were still with paroxysmal AFL and atrial tachycardia episodes, including3 cases of simple type and 6 cases of complex type who were discharged with oral digoxin and propafenone treatment at home.24 patients were followed up (3 months to 3 years and 4 months). 16 cases restored to sinus rhythm during hospitalization had no recurrence of AFL. Conclusions The overall treatment effects of AFL in infants were good. In simple type of AFL, most of patients did not need long-term antiarrhythmic drug therapy and the prognosis was good. The prognosis of treatment with conventional drug was poor in complex AFL group, with a higher rate of recurrence of AFL.
作者
王野峰
陈智
肖云彬
曾闵
杨舟
王祥
WANG Yefeng;CHEN Zhi;XIAO Yunbin;ZENG Min;YANG Zhou;WANG Xiang(Department of Cardiology, Hunan Children’s Hospital, Changsha 410007, Hunan, China)
出处
《临床儿科杂志》
CAS
CSCD
北大核心
2017年第2期125-128,共4页
Journal of Clinical Pediatrics
关键词
心房扑动
治疗
预后
婴儿
atrial flutter
treatment
prognosis
infant
