临床荟萃 ›› 2020, Vol. 35 ›› Issue (11): 1015-1018.doi: 10.3969/j.issn.1004-583X.2020.11.012

• 论著 • 上一篇    下一篇

儿童预激性心肌病4例并文献复习

  

  1. 河北医科大学第二医院 儿科,  河北 石家庄  050000
  • 出版日期:2020-11-20 发布日期:2020-10-21
  • 通讯作者: 冯琳, Email: seyfl@aliyun.com

Preexcitation cardiomyopathy in children: four cases report and literature review

  1. Department of Pediatrics,  the Second Hospital of Hebei Medical University,  Shijiazhuang 050000,  China
  • Online:2020-11-20 Published:2020-10-21
  • Contact: Corresponding author: Feng Lin, Email: seyfl@aliyun.com

摘要: 目的  分析4例预激性心肌病患儿的临床特点、治疗及随访,了解该病转归,同时探讨该病的影响因素。 方法  回顾性分析我院4例预激性心肌病患儿临床资料,并复习文献,了解该病转归及影响因素。结果  4例患儿均符合预激性心肌病诊断标准。其中3例行心内电生理学检查,发现存在旁道,给予射频消融术,病例1和病例2预激综合征消失,病例3仍有预激综合征;复查心脏超声示左心室均逐渐回缩,左心室功能均较前明显好转;此病预后良好。病例4尚未行射频消融术,目前正在随访中。结论  射频消融术为预激性心肌病首选治疗方法,预后良好。诊断时年龄、预激的负荷(持续性或间歇性)及预激的类型(旁道位置及数量)是预激性心肌病的影响因素。

关键词: 预激综合征, 导管消融术, 旁道, 不同步

Abstract: Objective  To analyze the clinical features,  treatment and followup of 4 children with preexcitation cardiomyopathy,  to understand the prognosis of the disease and to explore the influencing factors of preexcitation cardiomyopathy. Methods  The clinical data of 4 children with preexcitation cardiomyopathy in our hospital were analyzed retrospectively,  and the literature were reviewed to understand the prognosis and influencing factors of the disease.Results  All the 4 children met the diagnostic criteria of preexcitation cardiomyopathy. Totally 3 cases of them underwent intracardiac electrophysiological examination and were found with accessory pathways,  then  radiofrequency ablation was performed. The preexcitation syndrome of case 1 and case 2 disappeared,  while case 3 still had such syndrome. Echocardiography showed that the left ventricle gradually retracted and its function was significantly improved.  The prognosis of the disease was favorable. Case 4 had not yet undergone radiofrequency ablation and was currently at followup. Conclusion  The radiofrequency ablation is the first choice for the treatment of preexcitation cardiomyopathy and the prognosis is favorable. Age at diagnosis,  preexcitation load (persistent or intermittent) and type of preexcitation (location and number of accessory pathways) are the influencing factors of preexcitation cardiomyopathy.

Key words: preexcitation syndromes, , catheter ablation, accessory pathway, , nonsynchronous

中图分类号: