新生儿阵发性室上性心动过速36例分析

CLINICAL CHARACTERISTICS OF NEONATAL PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA OF 36 CASES

目的总结分析新生儿阵发性室上性心动过速（PSVT）的临床特点、治疗方法。方法回顾性分析本科36例新生儿PSVT患儿的一般资料、临床发病特点、心电图的表现、治疗方法、随访的结果和预后，并进行统计学分析。结果新生儿PSVT的主要临床表现是神萎、面色苍白、拒奶、发绀、心率〉210次／min，经心电图明确诊断为新生儿PSVT，10例患儿合并预激综合征。8例经兴奋迷走神经转复成功，21例经药物转复成功，7例经上述方法无效后经食管心房调搏行超速抑制后转复成功。所有患儿转复后均给予地高辛和心得安维持治疗3～6个月。随访2年，无复发。结论与年长儿不同，新生儿PSVT常无特异性的临床表现，诊断主要依据心电图，部分患儿可合并预激综合征。转复方法中兴奋迷走神经和药物转复均有一定疗效，以上二种方法无效时，采取食管心房调搏进行转搏更为迅速、有效、安全、可重复且无副作用，值得临床上推广应用。新生儿PSVT的预后较好。

Objective To summarize the clinical characteristics and its treatment of neonatal paroxysmal supraventricular tachycardia IPSVT）. Methods A retrospective analysis was performed for 36 cases of neonatal undergraduate paroxysmal supraventricular tachycardia with general information, clinical characteristics of the disease, ECG performance, treatment, followup results and prognosis. Results The main clinical manifestations of neonatal paroxysmal supraventricular tachycardia were god wilt, pale, refusing milk, cyanosis, heart rate greater than 210 beats /min, by ECG diagnosis of neonatal paroxysmal supraventricular tachycardia, and 10 cases of children with preexcitation syndrome. Eight patients with vagus nerve cardioversion success, 21 cases after drug cardioversion success, seven cases by the above method was invalid after transesophageal atrial pacing inhibition overspeed trip successful cardioversion. All patients were treated with cardioversion digoxin and propranolol maintenance treatment for 3 to 6 months, followed up for 2 years without recurrence. Conclusions Different from older children, neonatal paroxysmal supraventricular tachyeardia are often nonspecific clinical manifestations, diagnosed based on ECG, some children may be combined with WPW syndrome. Cardioversion method vagus nerve and drug cardioversion have a certain effect for them. When above two methods are invalid, to take transesophageal atrial pacing are transfected beat more rapidly, effective, safe, repeatable, and no side effects. It is better prognosis for neonatal paroxysmal supraventricular tachycardia and is worthy of clinical application.