儿童重症病毒性心肌炎42例临床特征及诊治分析

Analysis of Clinical Feature and Treatment of 42 Children's Patients with Severe Viral Myocarditis

目的总结42例儿童重症病毒性心肌炎(VM)的临床特征、疗效及预后。方法对42例儿童重症病毒性心肌炎临床资料回顾分析。结果病毒性心肌炎诊断缺乏典型临床特征和特异性辅助检查指标,常被基础疾病症状掩盖而导致延误治疗;本组42例儿童重症病毒性心肌炎中,76.2%有心脏症状,47.6%出现严重心脏并发症(如急性心力衰竭、心源性休克、致命性心律失常)。治疗总有效率78.6%,死亡率11.9%,14.3%(6/42)转为慢性。结论儿童病毒性心肌炎应结合病毒感染史,心悸、胸闷等临床症状和心肌损害的客观指标作出诊断;治疗无特效手段,注重综合治疗,对危重患者应及时监护和抢救;多数预后良好,极少数转为慢性。

Objective To summarize the clinical features,efficacy and prognosis of 42 children patients with severe viral myocarditis （VM）. Methods To retrospecitivly analyze the clinical data about 42 children patients with severe VM. Results There were the lack of typical clinical features and ancillary inspection targets on diagnosis, and no effects on clinical treatment, so that it was being concealed in the basis of disease symptoms and delayed treatment. Amidst this group patients （42 cases） of children with severe viral myocarditis, there was 76.2% patients with the heart symptoms and 47.6% patients with serious cardiac complications （ such as acute heart failure,cardiogenie shock,fatal arrhythmia）. Therapeutic result：total effective rate 78.6% ,morality 11.9% , 14. 3% to chronic. Conclusion To diagnose Viral myocarditis in children it hould be combined with the history of palpitations, chest tightness, and other clinical symptoms and objective indicators of myocardial damage. Because of no specific means of treatment, we should be focus on comprehensive treatment and timely care and rescue critically ill patients. The majority of children patients with severe VM are favorable prognosis and a very small number to chronic.