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目的探讨小儿暴发型心肌炎临床特点及有效、安全的诊治方法。方法收集自1984年1月-2006年3月上海地区6所医院收治的50例病例资料进行回顾性分析。结果50例患儿经治疗痊愈36例,好转2例,死亡12例,死亡率24．0％。临床特点为:好发年龄以学龄期儿童为主;均有前驱症状,以呼吸道、消化道症状多见,半数以上伴发热;起病急、进展快、起病初期以心外症状为主,表现为面色苍白、多汗、乏力、腹痛、抽搐等,起病24-48 h内出现严重心律失常和心功能不全;辅助检查以心电图改变最敏感且具有多样性;患儿自然病程约一个月。结论小儿暴发型心肌炎是一类严重威胁儿童生命的疾病,以抗心律失常和保护心肌为主,并应用心脏临时起搏的综合疗法,是一种有效、安全的治疗方法。
Objective To investigate the clinical characteristics of pediatric fulminant myocarditis and its effective and safe diagnosis and treatment. Methods The data of 50 cases admitted from 6 hospitals in Shanghai area from January 1984 to March 2006 were retrospectively analyzed. Results 50 cases of children recovered after treatment in 36 cases, 2 cases improved, 12 patients died, the mortality rate was 24.0%. Clinical features are as follows: the prevalence of age to school-age children are predominant; are prodromal symptoms to the respiratory tract, gastrointestinal symptoms more common, more than half with fever; acute onset, rapid progress, early onset of extra-cardiac symptoms, Manifested as pale, sweating, fatigue, abdominal pain, convulsions, etc., onset of severe arrhythmia within 24-48 h and heart failure; auxiliary examination to change the most sensitive and diverse ECG; children with natural course of about one month . Conclusions Pediatric fulminant myocarditis is a kind of serious disease which threatens the life of children. It is an effective and safe treatment for anti-arrhythmia and myocardial protection, and the combination therapy of temporary cardiac pacing.