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目的:总结小儿慢性心房扑动的治疗经验。方法:12例小儿慢性心房扑动患儿首先采用地高辛联合胺碘酮(7例)或地高辛联合普萘洛尔(5例)治疗,无效者3例行食管心房超速起搏治疗转律、2例予以同步直流电击复律,转律后应用胺碘酮口服维持,6例行射频消融治疗。结果:药物治疗后12例的心室率较治疗前降低,1例转为窦性心律。其余11例中行食管心房超速起搏及同步直流电击复律的5例转为窦性心律,应用胺碘酮可维持窦性心律;射频消融治疗的6例全部成功消融房内折返通道。结论:药物治疗可以减慢小儿心房扑动的心室率,食管心房超速起搏及同步直流电击复律能够终止慢性心房扑动发作,射频消融是根治小儿心房扑动最有效的方法。
Objective: To summarize the experience of treating children with chronic atrial flutter. Methods: Twelve cases of children with chronic atrial flutter were treated with digoxin combined with amiodarone (7 cases) or digoxin combined with propranolol (5 cases), and 3 cases were treated with esophageal atrial pacing Rotation, 2 cases were synchronized DC shock cardioversion, after the application of amiodarone after oral administration of maintenance, 6 cases of radiofrequency ablation. Results: The ventricular rate was decreased in 12 cases after drug treatment and in 1 case converted to sinus rhythm. Five of the remaining 11 cases of esophageal atrial pacing and synchronous DCR were converted to sinus rhythm, and amiodarone was used to maintain sinus rhythm. All 6 cases treated with radiofrequency ablation successfully ablated the atrial reentrant channel. Conclusion: Drug therapy can slow down the atrial flutter in children with ventricular rate, esophageal atrial pacing and synchronous DC shock cardioversion can terminate the onset of chronic atrial flutter, radiofrequency ablation is the most effective method of radical atrial flutter in children.