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目的分析我院植入临时起搏器患儿的临床特点。方法对2005年1月~2013年5月本院植入临时起搏器的病例进行回顾性分析。结果植入临时起搏器原因为Ⅲ度房室传导阻滞4例,永久起搏器故障引起的阿斯综合症1例,心跳骤停3例,频繁室速室颤4例,婴儿无休止性室速抗心律失常起搏1例,窦性心动过缓引起阿斯综合征1例。临床诊断爆发性心肌炎9例,先天性Ⅲ度房室传导阻滞1例,特发性婴儿无休止性室速1例,重症手足口病引起的心肌炎2例,永久起搏器故障引起的Ⅲ度房室传导阻滞1例。其中8例患儿痊愈出院;5例死亡;1例无效,改用药物治疗后转为窦性心律。植入临时起搏器时长1h~19d;3例患儿出现并发症,其植入临时起搏器的时长分别为3d、3d和19d。结论植入临时起搏器是治疗儿童致命性心律失常的有效方法,然后植入后需注意股静脉附壁血栓的形成,可采用口服抗凝药物的方法进行预防。
Objective To analyze the clinical features of children implanted with temporary pacemaker in our hospital. Methods From January 2005 to May 2013, we retrospectively analyzed the cases of temporary pacemaker implanted in our hospital from January 2005 to May 2013. Results Temporary pacemaker implanted in 4 patients with Ⅲ degree atrioventricular block, 1 case of Asperger syndrome caused by permanent pacemaker failure, 3 cases of cardiac arrest, 4 cases of frequent ventricular fibrillation, infants without stop Ventricular tachyarrhythmia pacing in 1 case, sinus bradyarrhythmia caused by Asperger syndrome in 1 case. Clinical diagnosis of 9 cases of fulminant myocarditis, congenital Ⅲ degree atrioventricular block in 1 case, idiopathic infants with uninterrupted ventricular tachycardia in 1 case, severe hand-foot-mouth disease caused by myocarditis in 2 cases, permanent pacemaker failure caused by Ⅲ Degree atrioventricular block in 1 case. Among them, 8 patients were cured and discharged; 5 died; 1 was ineffective and switched to sinus rhythm after treatment with drugs. Implantation of temporary pacemaker duration of 1h ~ 19d; 3 cases of complications occurred in children, their implanted temporary pacemaker duration were 3d, 3d and 19d. Conclusion The implanted temporary pacemaker is an effective method for the treatment of fatal arrhythmia in children, and then pay attention to the formation of the thrombus of the femoral vein after implantation, which can be prevented by the oral anticoagulant method.