發(fā)布時間：2018-04-29 00:09

  本文選題：肥厚型心肌病 + 兒童��； 參考：《重慶醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：總結(jié)小兒肥厚型心肌病臨床特點，減少誤診漏診，為早期識別、明確診斷和判斷預(yù)后提供指導(dǎo)。 方法：回顧性分析1993年11月-2012年12月本院38例肥厚型心肌病住院患兒，從年齡、性別、地區(qū)，臨床表現(xiàn)，輔助檢查，病情轉(zhuǎn)歸等方面進行總結(jié)。 結(jié)果：收集38例，隨訪30例（隨訪率78.9%）。小兒肥厚型心肌病常見臨床表現(xiàn)為生長發(fā)育落后（50.0%）、氣促（34.2%）、乏力/活動量下降（21.1%）、心悸（15.8%）、暈厥(7.9%)、頭暈（7.9%）、發(fā)紺（7.9%），同時合并呼吸道感染癥狀如咳嗽（52.6%）、發(fā)熱（21.1%）。大部分患兒有心臟雜音（55.3%），，部分有肝臟腫大（34.2%）表現(xiàn)。而年長兒或成人較為典型的表現(xiàn)如勞力性呼吸困難、胸痛在本組患兒中沒有出現(xiàn)。心電圖、24小時動態(tài)心電圖、超聲心動圖、心臟磁共振等輔助檢查明確疾病診斷，評估預(yù)后。該病需與引起心室肥厚的疾病（如高血壓、主動脈縮窄、嗜鉻細(xì)胞瘤等）鑒別，監(jiān)測血壓有重要價值。隨訪患兒中死亡者比例較高，占40.0%，可能與發(fā)病年齡小、病情嚴(yán)重、合并嚴(yán)重呼吸道感染有關(guān)。綜合臨床表現(xiàn)，完善相關(guān)輔助檢查，明確疾病診斷，進一步評估風(fēng)險和判斷預(yù)后。 結(jié)論：小兒肥厚型心肌病臨床表現(xiàn)多樣化，較成人不典型，容易誤診和漏診。該病的診斷主要依靠輔助檢查。首次出現(xiàn)癥狀的年齡越小者，預(yù)后越差。
[Abstract]:Objective: to summarize the clinical characteristics of hypertrophic cardiomyopathy in children, reduce misdiagnosis and misdiagnosis, and provide guidance for early identification, diagnosis and prognosis. Methods: 38 hospitalized children with hypertrophic cardiomyopathy from November 1993 to December 2012 were retrospectively analyzed in terms of age, sex, area, clinical manifestation, auxiliary examination and prognosis. Results: 38 cases were collected and 30 cases were followed-up (follow-up rate 78.9%). The common clinical manifestations of hypertrophic cardiomyopathy in children were as follows: 50. 0% growth and development retardation, 34. 2% shortness of breath, 21. 1% of fatigue / activity, 15. 8% of palpitation, 7. 9% of syncope, 7. 9% of dizziness, 7. 9% of cyanosis. At the same time, the symptoms of respiratory tract infection such as cough 52.6%, fever 21. 1% were involved. Most of them had heart murmur 55.3 and some had hepatomegaly. The typical manifestations of elderly or adult children, such as laborious dyspnea, chest pain did not occur in this group. 24-hour ambulatory electrocardiogram, echocardiography and cardiac magnetic resonance were used to diagnose the disease and evaluate the prognosis. The disease needs to be distinguished from diseases that cause ventricular hypertrophy (such as hypertension, aortic coarctation, pheochromocytoma, etc.) and monitoring of blood pressure is of great value. The proportion of death was higher (40.0%) in the follow-up children, which may be related to the younger age, the severe disease and the severe respiratory tract infection. Comprehensive clinical manifestations, improve the relevant auxiliary examination, clear diagnosis, further assessment of risk and prognosis. Conclusion: the clinical manifestations of hypertrophic cardiomyopathy in children are more diversified than those in adults, and are more easily misdiagnosed and missed. The diagnosis of the disease mainly depends on auxiliary examination. The younger the first symptom, the worse the prognosis.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2013
【分類號】：R725.4

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