新生儿恶性心律失常28例临床分析

Clinical analysis of 28 cases of non benign neonatal arrhythmias

目的探讨新生儿恶性心律失常的病因、临床特征及转归。方法回顾性分析2005年1月至2010年1月诊断的27例恶性心律失常新生儿的临床资料。结果 27例患儿中,男15例,女12例;早期新生儿14例,晚期新生儿13例;胎龄≤32周6例,>32周21例。19例快速性心律失常新生儿中,呼吸道感染14例;8例缓慢性心律失常新生儿中,先天性心脏病3例,电解质紊乱2例,重度窒息合并败血症2例,重度窒息1例。缓慢性心律失常新生儿的发病日龄、胎龄明显小于快速性心律失常新生儿,差异有统计学意义(P均<0.005)。快速性心律失常治愈率89.5%,有效率100%;而缓慢性心律失常治愈率为0%,有效率12.5%,差异有统计学意义(P均<0.005)。结论新生儿快速性心律失常与缓慢性心律失常临床特征及发病机制各不相同,预后差异大。

Objective To discuss the etiology, clinical features and prognosis of non benign neonatal arrhythmias. Method Clinical data of 27 cases of non benign neonatal arrhythmias diagnosed from January 2005 to January 2010 were retrospectively analyzed. Results Among 27 neonats, there were 15 male and 12 female. Fourteen cases were early neonatal and 13 were late neonatal. Gestational age was less than 32 weeks in 6 cases, and more than 32 weeks in 21 cases. In 19 cases with tachyarrhythmia, 14 cases were induced by respiratory infection. The causes of 8 newborns with bradycardia arrhythmia were congenital heart disease （3 cases）, electrolyte disturbance （2 cases）, severe asphyxia with sepsis （2 cases）, and severe asphyxia （1 case）. The onset age and gestational age were lower in cases with bradycardia arrhythma that those in cases with tachyarrhythmia （P〈0.005）. The cure rate and effective rate of tachyarrhythmia was 89.5% and 100%, of bradycardia arrhythmia was 0% and 12.5%, respectively, and the differences were significant （P〈0.005）. Conclusion Clinical characteristics, pathogenesis and prognosis were different between tachyarrhythmia and bradycardia arrhythmia in neonates.