小儿右束支传导阻滞的临床意义分析

Analysis of the clinical significance in children's right bundle branch block

目的:探讨小儿右束支传导阻滞(RBBB)的心电图特征及其临床诊断价值。方法:对159例表现为RBBB患儿的临床资料进行回顾性分析。结果:159例中器质性心脏病患儿97例(病毒性心肌炎20例,川崎病20例,风湿性心肌炎2例,心包炎4例,心肌病2例,感染性心内膜炎2例,原发性心内膜弹力增生症3例,充血性心力衰竭5例,呼吸衰竭8例,先天性心脏病31例),非器质性心脏病患儿62例。器质性心脏病患儿QRS时限>0.10～0.12s,ST段下移,T波低平及心律失常的发生率明显高于非器质性心脏病患儿。结论:儿童RBBB可因各类疾病引起。当RBBB患儿出现电轴重度右偏或左偏,ST段下移,T波低平,并伴有其他心律失常时提示为器质性心脏病变。

Objective：To investigate the ECG features of children＇s right bundle branch block （RBBB） and the diagnosis value in clinical disease.Method：The clinical data of 159 children with RBBB were retrospectively analyzed.Result：There were 62 cases without organic heart disease in 159 cases,and 97 cases with organic heart disease,in which there were 20 cases of viral myocarditis,20 cases of Kawasaki disease,2 cases of rheumatic myocarditis,4 cases of pericarditis,2 cases of primary cardiomyopathy,2 cases of infective endocarditis,3 cases of primary endocardial elastic hyperplasia,5 cases of congestive heart failure,8 cases of respiratory failure,31 cases of congenital heart disease.The incidence of QRS time exceeding the normal,ST segment moveding downwards,T wave of low-lying and with arrhythmia in patients of organic heart disease was significantly higher than non-organic heart disease.Conclusion：Children＇s RBBB may be due to various diseases.When children with RBBB occurr the electric axle partial to right or left seriously,ST segment moveding downwards,T wave of low-lying,and with other arrhythmia,maybe it focuses maybe the evidence of organic heart disease.