摘要
目的:探讨重症肺炎患儿心律失常发生的原因及治疗对策。方法:调查深圳市宝安区妇幼保健院儿科重症监护病房(PICU)2004年1月至2006年12月共收治临床资料完整的重症肺炎患儿90例,对患儿临床特征与心律失常的关系进行单因素方差分析。结果:90例中有42例重症肺炎患儿出现心律失常56例次,发生率46.7%(42/90),其中,窦性心动过缓3例,频发房性早搏10例,房性心动过速5例,室上性心动过速3例,心房颤动2例,室性早搏8例,室性心动过速2例,室性早搏伴短阵室速2例,一度房室传导阻滞4例,二度房室传导阻滞2例,一度房室传导阻滞伴室性早搏1例。低年龄(χ2=11.43,P=0.000)、Ⅰ型呼吸衰竭(χ2=7.23,P=0.007)、心功能不全(χ2=19.44,P=0.000)、肌钙蛋白升高(χ2=16.99,P=0.000)及低血钾(χ2=19.74,P=0.000)是重症肺炎心律失常影响因素。结论:心律失常是重症肺炎患儿早期较严重并发症,低年龄、Ⅰ型呼吸衰竭、心功能不全、心肌损害程度及低血钾等与重症肺炎患儿心律失常有密切关系,及时有效的氧疗,及早纠正心功能不全,控制感染,保护心肌治疗,维持内环境稳定,防止电解质紊乱和缺氧、酸中毒的发生,是防止重症肺炎患儿心律失常的有效措施。
Objective: To investigate the related factors of arrhythmias in children with severe pneumonia and its preventive methods, Methods: All clinical data of 90 eases with severe pneumonia from Jan. 2004 to Dee 2006 were reviewed. Results: 56 arrhythmias occurred in 42 patients (46.7 % ), including premature complexes, supraventrieular taehyeardia, atrial fibrillation, Sinus bradyeardia, Ⅰ° and Ⅱ ° AVB et al. Being young, eardiopulmonary insufficiency, myocardieal damage and hypokalemia were the related factors of arrhythmias in children with severe pneumonia (P 〈 0.01). Conclusions: Arrhythmia was a severe early complication in children with severe pneumonia. Early and effective oxygen therapy, myocardial protection, infection control, maintaining of normal circulation, and prevention of electrolytes and anoxia/aeidosis may be the most effective methods to prevent children with severe pneumonia from arrhythmias.
出处
《儿科药学杂志》
CAS
2007年第6期24-25,49,共3页
Journal of Pediatric Pharmacy
关键词
重症肺炎
心律失常
危险因素
儿童
Severe pneumonia
Arrhythmias
Risk factors
Children