在没有药物治疗的情况下治疗婴儿心跳上心脏的结果
Anthony G Pompa1, Martin J LaPage2
1Division of Pediatric Cardiology, Department of Pediatrics, Washington University School of Medicine, 1 Children's Pl, 8th Floor NWT, St. Louis, MO, 63108, USA. pompa@wustl.edu.
Pediatric cardiology
|August 10, 2023
概括
对于心脏正常的婴儿来说,在第一个脑上脉高动 (SVT) 发作后放弃抗节律药物是安全的. 这种方法减少了住院和药物负担,使父母能够有效地管理SVT.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 电子生理学 电子生理学
- 新生儿医学 新生儿医学
背景情况:
- 婴儿的上心室性心跳动 (SVT) 往往会促使抗心律失常治疗,以预防心跳动引起的心肌病变.
- 一种常见的替代实践包括对监测和寻求护理的家长教育,而不是立即的药理干预.
- 评估这种非药理学方法的结果对于优化婴儿SVT管理至关重要.
研究的目的:
- 为了比较婴儿SVT第一个发作时的非药物管理与抗心律失常治疗的结果.
- 评估复发率,住院时间长度,急诊室的访问,以及心动力衰竭引起的心肌病变的发展.
主要方法:
- 对于第一个SVT发作 (2014-2021) 的婴儿进行了回顾性单中心研究.
- 排除标准包括非再进入性动脉节律失常症,特定的心脏病状况和异常心室功能.
- 使用和不使用抗心律失常药物管理的婴儿之间的结局的比较.
主要成果:
- 在未接受治疗组中,SVT复发发生在28%的患者中,而在抗心律失常组中,这一比例为50% (p=0.12).
- 非治疗组的住院时间明显较短 (1天 vs 3天,p<0.01).
- 没有接受治疗的婴儿不太可能因复发性SVT而出现在急诊室 (6%对32%,p<0.01);在任何一组中都没有发生心肌病.
结论:
- 父母教育的非药物管理是婴儿在第一次SVT发作后心脏结构和功能正常的婴儿的安全和有效策略.
- 这种方法可以避免药物负担,并减少医疗保健的使用量,而不会影响患者的安全.
- 家长的授权和舒适在家中管理临床上微不足道的高心率是显著的好处.
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