儿童暴发性心肌炎的早期诊断及治疗进展

Progress of early diagnosis and treatment in fulminant myocarditis in children

暴发性心肌炎是一种以急性血流动力学障碍为主要表现的心肌炎,临床表现多样且病死率极高。暴发性心肌炎早期诊断需依靠血清学指标、心电图、超声心动图等进行综合分析,心脏磁共振成像检查在心肌炎诊断中也具有很好的应用价值。传统的暴发性心肌炎治疗,包括对症支持、抗病毒及免疫疗法等,但对危重患儿往往难以奏效。体外膜肺氧合技术(ECMO)的开展,大大提高了儿童暴发性心肌炎的抢救成功率,成为救治儿童暴发性心肌炎的可靠手段。文章综述目前儿童暴发性心肌炎的诊断及最新治疗进展。

Fulminant myocarditis a kind of myocarditis with rapid hemodynamic compromise, diverse clinical manifestations and high mortality. Early diagnosis needs a comprehensive analysis of serum biomarkers,？electrocardiogram, and echocardiography, etc. Cardiac MRI has become a useful tool for the diagnosis of myocarditis. Traditional treatment mainly includes supportive regime to release symptoms, antiviral treatment, and immunotherapy, which may not be effective in some critical patients. With the help of extracorporeal membrane oxygenation （ECMO）, survival rate in children with fulminant myocarditis is greatly improved. Thus, ECMO becomes an effective means in children with fulminant myocarditis. This article aims to review the progress of diagnosis and the latest treatment of fulminant myocarditis in children.