98例小儿晕厥的临床分析

Clinical analysis of 98 cases of paediatric syncope

目的探讨小儿晕厥的病因及美托洛尔治疗小儿血管迷走性晕厥(VVS)的疗效,为临床诊治提供依据。方法采用卧位立位血压、血常规、血糖浓度、血气分析、心电图、超声心动图、头颅CT、脑电图、24 h动态心电图以及直立倾斜试验(HUT)等检测指标,以鉴别得病的原因;将VVS患儿随机平均分为治疗组(口服美托洛尔片)及对照组(口服复合维生素B片),观察两组患者临床晕厥发作次数及HUT结果。结果小儿自主神经介导晕厥发病率最高(64.3%),其中VVS晕厥发病最多(66.7%)。治疗组经美托洛尔治疗后有效率为85.7%,HUT阴转率为66.7%;对照组有效率为42.8%,HUT阴转率为44.4%;两组有效率差异有统计学意义(P<0.05)。结论小儿自主神经介导晕厥发病率最高,尤其以VVS晕厥最多见;口服美托洛尔片可有效治疗小儿VVS晕厥。

Objective To study the etiology of paediatric syncope and the curative effect of metoprolol on pediatric vasovagal syncope （VVS） to provide the basis for clinical diagnosis and treatment.Methods The blood pressure in lying position,blood routine test,blood sugar concentration,blood gas analysis,electroeardiogram,echoeardiography,cranial com- puted tomography （CT）,electroencephalogram,24 h dynamic electrocardiogram,and head-up tilt test （HUT） were used to identify the cause of the disease;Children with VVS were randomly divided into treatment group （metoprolol tablets o- rally） and control group （Vitamin B tablets orally）,the clinical onset of syncope and HUT outcome of the two groups was observed.Results The incidence of paediatric autonomic nerve mediated syncope was the highest （64.3%）,in which the highest was VVS syncope pathogenesis （66.7%）.The effective rate of the treatment group after treatment with metopro- 1ol was 85.7% and the negative conversion rate of HUT was 66.7%;the effective rate of the control group was 42.8% and the negative conversion rate of HUT was 44.4% ,there was significant difference of the result between the two groups （P〈0.05）.Conclusion The incidence of paediatrie autonomic nerve mediated syncope is the highest,especially VVS syncope;Oral administration of metoprolol tablets can effectively treat paediatric VVS syncope.