重症监护病房新生儿心律失常的临床特点及预后

Clinical features and prognosis of arrhythmia in the neonatal intensive care unit

目的探讨新生儿重症监护病房(NICU)中新生儿心律失常的临床特点及预后。方法对本院NICU 2007年7月至2011年1月收治的心律失常新生儿资料进行回顾性分析,结性或交界性心律、房性早搏和室性早搏为良性心律失常组,室上性快速心律失常、Ⅱ度Ⅱ型以上窦房传导阻滞、Ⅱ度以上房室传导阻滞和室性心动过速为非良性心律失常组,总结两组患儿的临床特点及预后。结果 48例心律失常新生儿,其中男32例,女16例;足月儿37例,早产儿11例。心律失常以非良性心律失常占多数,共36例(75.0%),均有临床表现,其中12例(25.0%)入院时即存在呼吸、循环衰竭;感染、缺氧、器质性心脏病、电解质紊乱及酸碱失衡为主要高危因素;心律失常类型以快速心律失常为主,共30例(83.3%)。良性心律失常多无症状,经病因治疗或抗心律失常治疗均痊愈或好转,非良性心律失常中死亡4例,未愈3例。结论 NICU新生儿心律失常中非良性心律失常相对较多,多数有临床表现,且需及时治疗,预后与原发病及心律失常类型有关,室上性心律失常相对预后好,室性心律失常预后差。

Objective To discuss the clinical features and prognosis of arrhythmia in the neonatal intensive care unit. Methods Totally 48 neonates were included in this study between July 2007 to January 2011. We analyzed the patients＇ data. Thirty six of them were followed up. Results Among 48 patients with arrhythmia, 32 cases were male and 16 cases were female. Thirty seven cases were term infhnts. Patients with benign arrhythmia were asymptomatic. Thirty six neonates suffered from non-benign arrhythmia had symptoms, and 12 of them complicated with respiratory failure and heart failure when admitted. Several neonatal risk factors were associated with arrhythmia included infection, hypoxia, organic cardiopathy, and so on. Most of non-benign arrhythmias were associated with tachycardia. Patients with benign arrhythmias had better prognosis. Four babies with non-benign arrhythmia died. Conclusions Non-benign arrhythmias were the main types of arrhythmia in the NICU and most of them needed treatment. The prognosis is associated with the primary disease and the different type of arrhythmia.