婴儿房性心动过速23例诊疗分析

Analysis of diagnosis and treatment of 23 infants with atrial tachycardia

目的探讨婴儿房性心动过速(AT)的临床特点、治疗效果及预后。方法回顾分析2014年8月至2016年11月23例婴儿AT的临床资料,观察治疗效果及预后。结果23例AT患儿中,无休止性发作5例,间歇性发作18例。心功能不全13例,其中5例合并心动过速性心肌病(TIC)。心脏彩超显示,房间隔缺损3例,卵圆孔未闭6例,室间隔缺损1例,室间隔缺损合并卵圆孔未闭2例,室间隔缺损合并房间隔缺损1例,室间隔缺损合并主动脉缩窄1例。出院时显效11例,有效8例,无效4例。心功能正常患儿与心功能不全患儿出院时疗效比较差异无统计学意义(P>0.05)。出院后随访12个月,19例AT消失,1例进展为病态窦房结综合征,3例失访。结论婴儿AT发病隐蔽。予强心及抗心律失常治疗中短期随访总体预后良好,仍需长期随访以进一步了解其预后情况。

Objective To study the clinical characteristics,respond of treatment and prognosis in infants with atrial tachycardia(AT).Methods The clinical data of 23 infants with AT from August 2014 to November 2016 were retrospectively analyzed.The respond of treatment and prognosis were observed.Results Of all the 23 infants with AT,incessant AT was in 5 cases,and paroxysmal AT was in 18 cases.There were 13 infants diagnosed with AT combined with cardiac insufficiency,and among them,5 cases were combined with tachycardia induced cardiomyopathy(TIC).Echocardiography showed that atrial septal defect in 3 cases,patent foramen oval in 6 cases,ventricular septal defect in 1 case,ventricular septal defect combined with patent foramen oval in 2 cases,ventricular septal defect combined with atrial septal defect in 1 case,and ventricular septal defect combined with coarctation of the aorta in 1 case.The curative effect was excellent in 11 cases,effective in 8 cases,and ineffective in 4 cases at discharge.There was no statistical difference in curative effect between patients with normal cardiac function and cardiac insufficiency at discharge(P>0.05).The infants were followed up for 12 months,AT disappeared in 19 cases,1 case progressed to sick sinus syndrome,and 3 cases were lost in follow-up.Conclusions AT can be insidious in infants,but with a favorable prognosis if treated with cardiotonic drugs and antiarrhythmic drugs during the short and mid-term follow-up.Long-term follow-up should be taken to learn more about the prognosis.