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目的:总结暴发性心肌炎的临床特征与治疗。方法:对我院1997年6月~2014年8月收治的22例暴发性心肌炎儿童的临床资料进行回顾性分析。结果:22例中男11例,女11例;年龄2天~18岁,平均年龄8.96岁。患儿临床表现不典型,多以心外表现为首发症状,入院时误诊14例(63.6%)。确诊后19例予以大剂量糖皮质激素;11例同时予以大剂量丙种球蛋白(IVIG)等治疗,其中9例痊愈,2例死亡。22例中最后13例治愈,6例死亡,3例放弃治疗。结论:暴发性心肌炎临床缺乏特征性,早期易于误诊。应用大剂量糖皮质激素和IVIG等综合治疗有助于提高抢救成功率。
Objective: To summarize the clinical features and treatment of fulminant myocarditis. Methods: The clinical data of 22 children with fulminant myocarditis admitted to our hospital from June 1997 to August 2014 were analyzed retrospectively. Results: There were 11 males and 11 females in 22 cases, ranging in age from 2 days to 18 years with a mean age of 8.96 years. Children with atypical clinical manifestations, mostly extracardiac performance as the first symptom, misdiagnosed in 14 cases (63.6%). 19 cases were diagnosed with high-dose glucocorticoid; 11 cases were treated with high-dose gamma globulin (IVIG), of which 9 cases recovered and 2 died. Of the 22 patients, the last 13 were cured, 6 died and 3 gave up treatment. Conclusions: The clinical features of fulminant myocarditis are characterized by lack of early misdiagnosis. Application of high-dose glucocorticoid and IVIG and other comprehensive treatment will help to improve the success rate of rescue.