急性重症病毒性心肌炎患者临床表现及治疗方法研究

The clinical characteristics and treatment of acute severe viral myocarditis

目的 分析急性重症病毒性心肌炎病例临床特征及有效治疗方法,为临床医师诊疗提供可靠依据,保障患者生活质量及生命安全.方法 通过以下三种方式：（1）电话回访2010年来陕西省志丹县人民医院就诊的17例急性重症病毒性心肌炎患者；（2）对救护患者的医护人员进行询问；（3）查阅病历,了解患者临床表现、检查结果、治疗方法和临床疗效等.使用SPSS13.0软件进行统计学分析.结果 17例急性重症病毒性心肌炎患者中,11.76％需植入心脏永久起搏器；47.06％治疗后出现后遗症（其中50.00％为扩张型心肌病）；52.94％患者死亡,死亡病例中77.78％为急性期死亡.结论 临床医师应根据患者临床表现、检查结果,结合患者是否有病毒感染史综合判断,提高病毒性心肌病诊断正确率,给予及早、有效的治疗,保障患者生命安全.

Objective To analyze the cases of acute severe viral myocarditis clinical characteristics and effective treatment, provide a reliable basis for the diagnosis and treatment of clinicians, guarantee life quali- ty and safety in the patients. Methods The clinical data of 17 acute severe viral myocarditis patients who received medical treatment in Zhidan county of Shanxi province people~ hospital in 2010 were collected. The information of clinical manifestations, various clinical examination results, methods of treatment, and the clinical curative effect of the cases were collected through telephone interview, medical personnel question- naire surveys, and case history reading. Results Of the 17 acute severe viral myocarditis patients, 11.76% required permanent pacemaker implantation; 47.06% patients had complications （50% of the pa- tients had dilated cardiomyopathy） ; 52. 94% of them died （most of them were acute death） accounting for 77.78% of the death. Conclusions The clinical diagnosis should base on clinical manifestations, clinical findings, and history of viral infection. We should improve the diagnosis correct rate and provide early treat- ment, improve the treatment effect of the patients, guarantee the safety of the patients.