新生儿阵发性室上性心动过速的临床特点及治疗效果

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目的探究新生儿阵发性室上性心动过速(PSVT)的临床特点及药物治疗效果。方法选取2014年1月-2016年12月十堰市人民医院收治的PSVT患儿60例为研究对象,根据心电图有无心室预激表现分为隐匿通路组和预激综合征(WPW)组,每组各30例。根据患儿具体情况给予同步电复律、迷走神经刺激及药物治疗等方案,比较两组患儿的临床表现、治疗和预后。结果 WPW组初次发作心率高于隐匿通路组,差异有统计学意义(P<0.05)。WPW组实施迷走神经刺激的比例高于隐匿通路组,差异有统计学意义(P<0.05)。两组实施同步电复律的比例及用药情况比较,差异无统计学意义(P>0.05)。除WPW组2例患儿死亡外,余58例患儿均复律后好转。出院后WPW组维持用药比例和复发住院比例高于隐匿通路组,差异有统计学意义(P<0.05)。结论合并心室预激表现的PSVT患儿治疗方式与无心室预激表现的患儿无异,但前者病情较重,实施迷走神经刺激的几率较高,多数患儿出院后需维持用药,应密切随访,注意抗心律失常药物的不良反应。 Objective To investigate the clinical features and therapeutic effects of paroxysmal supraventricular tachycardia (PSVT) in neonates. Methods Sixty children with PSVT admitted from January 2014 to December 2016 in Shiyan People’s Hospital were enrolled in this study. Patients were divided into two groups according to the presence or absence of ventricular pre-excitation: Group of 30 cases. According to the specific circumstances of children given cardioversion, vagus nerve stimulation and drug treatment programs, the clinical manifestations, treatment and prognosis of two groups were compared. Results The heart rate of the first episode of WPW group was higher than that of the hidden channel group (P <0.05). The proportion of vagus nerve stimulation in WPW group was higher than that in occluded pathway group, with significant difference (P <0.05). There was no significant difference between the two groups in the proportion of synchronized cardioversion and medication (P> 0.05). Except WPW group 2 cases of children died, more than 58 cases of children were recovered after cardioversion. After discharge from the hospital, the proportion of maintenance medication and recurrence hospitalization in WPW group was higher than that in occluded access group, with significant difference (P <0.05). Conclusions The treatment of PSVT patients with ventricular preconditioning is the same as that of patients without ventricular pre-excitation, but the former is more severe and has a higher risk of vagus nerve stimulation. Most children need to maintain medication after discharge and should be closely followed up , Pay attention to anti-arrhythmic drug adverse reactions.
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