儿童扩张性心肌病合并心室内血栓2例临床分析及文献回顾

Children dilated cardiomyopathy complicated ventricular thrombus two cases of clinical analysis and review of the literature

目的探讨儿童扩张性心肌病形成心室内血栓高危因素、治疗方法及预后。方法回顾性分析河南省郑州市儿童医院2013~2015年收治2例扩张性心肌病合并心室内血栓的临床资料,并进行文献复习。结果2例患儿平素均未规律服用改善心功能药物及抗凝药物。病例1,女,6岁8个月,同时给予肝素、阿司匹林、华法林联合抗凝治疗12天,血栓吸收顺利,随访6个月,未出现血栓。例2,男,6岁2个月,先给予肝素抗凝,出院前加用华法林,住院56天后血栓吸收,期间出现脑梗死,随访2个月,未出现血栓。结论不规范治疗是儿童扩张性心肌病发生心室内血栓的重要高危因素;定期随访、规范服用改善心功能及抗凝药物,积极处理并发症,有助于改善预后。

Objective To investigate ventricular thrombosis of risk factors,treatment and prognosis in children of dilated cardiomyopathy.Method A retrospective analysis of clinical data of 2 cases of dilated cardiomyopathy complicated ventricular thrombi in Children＇s Hospital of Zhengzhou in 2013—2015 years,and review related literature.Result Two cases are not usually regular use of drugs to improve heart function and anticoagulant drugs.Example1,female,6 years and 8 months,heparin,aspirin,warfarin were been used for 12 days,thrombus were absorbed,after 6 months of follow-up,no recurrence.Example 2,male,6 years and 2 months,First giving heparin was been used first,and then warfarin was been given,After 56 days of hospitalization thrombosis absorbed,cerebral infarction occurred,after 2 months of follow-up,no recurrence.Conclusion No standard treatment is an important risk factor for child dilated cardiomyopathy ventricular thrombus;Regulate following-up,taking drugs of improving heart function and anticoagulant,activly treating complications can help to improve the prognosis