小儿宽QRS波心动过速的鉴别探索

Differential diagnosis of wide QRS complex tachycardia in children

目的探讨小儿宽QRS波心动过速的临床特点及心电图鉴别诊断方法。方法选取本院2017年1月至2020年2月间24例突发心动过速且行床边12导联体表心电图检查示宽QRS心动过速患儿为研究对象,通过对其心电图特点、临床症状与各项体征进行综合性分析,探索小儿宽QRS波心动过速的临床特点。结果小儿宽QRS波心动过速鉴别诊断时需紧密结合患儿临床症状、基础疾病与各项体征做出综合判断,高钾血症造成的室内传导异常为本文的主要原因,而室性心律失常占较小比率。以上患儿如诊断方向正确,处理及时多数预后较好。结论小儿宽QRS心动过速心电图鉴别诊断与成人有所不同,提高诊断符合率对疾病的临床治疗和预后均有着指导性意义。

Objective To investigate the clinical characteristics and ECG differential diagnosis of wide QRS complex tachycardia in children.Methods A total of 24 children with sudden tachycardia and the surface 12 lead ECG examination showed wide QRS complex tachycardia in our hospital from January 2017 to February 2020 were selected for comprehensive analysis of their clinical symptoms,signs and ECG characteristics.Results The differential diagnosis of wide QRS complex tachycardia in children requires a comprehensive judgment based on the clinical symptoms,underlying diseases and various signs of the child,the main cause of wide QRS tachycardia in children was intraventricular conduction disturbances caused by hyperkalemia,while ventricular arrhythmia accounts for a small proportion.If the diagnosis direction was correct and the treatment is timely,most of them have good prognosis.Conclusions The differential diagnosis of wide QRS tachycardia in children is different from that in adults.Improving the diagnostic coincidence rate is of guiding significance to the clinical treatment and prognosis of the disease.