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目的总结分析新生儿阵发性室上性心动过速(PSVT)的临床特点、治疗方法。方法回顾性分析本科36例新生儿PSVT患儿的一般资料、临床发病特点、心电图的表现、治疗方法、随访的结果和预后,并进行统计学分析。结果新生儿PSVT的主要临床表现是神萎、面色苍白、拒奶、发绀、心率>210次/min,经心电图明确诊断为新生儿PSVT,10例患儿合并预激综合征。8例经兴奋迷走神经转复成功,21例经药物转复成功,7例经上述方法无效后经食管心房调搏行超速抑制后转复成功。所有患儿转复后均给予地高辛和心得安维持治疗3~6个月。随访2年,无复发。结论与年长儿不同,新生儿PSVT常无特异性的临床表现,诊断主要依据心电图,部分患儿可合并预激综合征。转复方法中兴奋迷走神经和药物转复均有一定疗效,以上二种方法无效时,采取食管心房调搏进行转搏更为迅速、有效、安全、可重复且无副作用,值得临床上推广应用。新生儿PSVT的预后较好。
Objective To summarize the clinical features and treatment of paroxysmal supraventricular tachycardia (PSVT) in neonates. Methods Retrospective analysis of 36 cases of neonatal pediatric PSVT in children with general information, clinical features, ECG performance, treatment, follow-up results and prognosis, and statistical analysis. Results The main clinical manifestations of neonatal PSVT were wilted, pale, refused to milk, cyanosis, heart rate> 210 beats / min, diagnosed as neonatal PSVT by electrocardiogram and 10 cases with pre-excitation syndrome. 8 cases of successful vagal nerve transfer success, 21 cases of successful drug transfer, 7 cases after the above method is invalid after transesophageal atrial pacing line oversupply and success. All children were given digoxin and anxiety after the transfer of maintenance treatment for 3 to 6 months. Follow-up 2 years, no recurrence. Conclusion Unlike the older children, neonatal PSVT often non-specific clinical manifestations, the diagnosis is mainly based on ECG, some children may be combined with Wolff-Parkinson’s syndrome. Reply to the method of excitement vagal nerve and drug conversion have a certain effect, the above two methods is invalid, esophageal atrial pacing to take more rapid, effective, safe, repeatable and without side effects, it is worth promoting the clinical application. The prognosis of neonatal PSVT is better.