98例小儿晕厥临床分析.docVIP

98例小儿晕厥临床分析 　　[摘要] 目的 探讨小儿晕厥的病因及美托洛尔治疗小儿血管迷走性晕厥（VVS）的疗效，为临床诊治提供依据。 方法 采用卧位立位血压、血常规、血糖浓度、血气分析、心电图、超声心动图、头颅CT、脑电图、24 h动态心电图以及直立倾斜试验（HUT）等检测指标，以鉴别得病的原因；将VVS患儿随机平均分为治疗组（口服美托洛尔片）及对照组（口服复合维生素B片），观察两组患者临床晕厥发作次数及HUT结果。 结果 小儿自主神经介导晕厥发病率最高（64.3%），其中VVS晕厥发病最多（66.7%）。治疗组经美托洛尔治疗后有效率为85.7%，HUT阴转率为66.7%；对照组有效率为42.8%，HUT阴转率为44.4%；两组有效率差异有统计学意义（P 　　[关键词] 小儿晕厥；血管迷走神经性晕厥；美托洛尔 　　[中图分类号] R725 [文献标识码] A [文章编号] 1674-4721（2013）11（b）-0045-02 　　Clinical analysis of 98 cases of paediatric syncope 　　WANG Yi-chang 　　Department of Pediatrics，Mianhu Overseas Chinese Hospital of Jiexi County，Jieyang City in Guangdong Province，Jiexi 515438，China 　　[Abstract] Objective To study the etiology of paediatric syncope and the curative effect of metoprolol on pediatric vasovagal syncope （VVS） to provide the basis for clinical diagnosis and treatment.Methods The blood pressure in lying position，blood routine test，blood sugar concentration，blood gas analysis，electrocardiogram，echocardiography，cranial computed tomography （CT），electroencephalogram，24 h dynamic electrocardiogram，and head-up tilt test （HUT） were used to identify the cause of the disease；Children with VVS were randomly divided into treatment group （metoprolol tablets orally） and control group （Vitamin B tablets orally），the clinical onset of syncope and HUT outcome of the two groups was observed.Results The incidence of paediatric autonomic nerve mediated syncope was the highest （64.3%），in which the highest was VVS syncope pathogenesis （66.7%）.The effective rate of the treatment group after treatment with metoprolol was 85.7% and the negative conversion rate of HUT was 66.7%；the effective rate of the control group was 42.8% and the negative conversion rate of HUT was 44.4%，there was significant difference of the result between the two groups （P0.05）。 　　1.2 方法 　　对98例患者病情进???详细询问并体检，进行卧位立位血压、血常规、血糖浓度、血气分析、心电图、超声心动图、头颅CT、脑电图、24 h动态心电图以及直立倾斜试验（HUT）等检测指标，以鉴别得病的原因[3]。患儿发生晕厥即让其躺下、平卧、去枕，呈头低足高位，并解开衣领、腰带等束缚身体的衣物以利呼吸，注意保持环境安静和保暖。按压或针刺人中穴、内关穴或压眶上神经，