6岁以下儿童直立倾斜试验探讨

目的：探讨6岁以下儿童直立倾斜试验（HUTT）的临床价值和安全性。方法：对2000年9月至2011年8月对144例因不明原因晕厥、头晕等症状就诊的儿童（年龄2～6岁，男81例，女63例）的HUTT结果进行回顾性分析。结果：（1）HUTT依从性：144例受试儿童中8例仅完成了基础直立倾斜试验，136例完成了舌下含服硝酸甘油倾斜试验。（2）HUTT安全性：受试儿童完成HUTT后均未出现严重副反应。（3）HUTT阳性率：HUTT阳性率为22.2%（32/144），男童（18例）与女童（14例）阳性率差异无统计学意义（P>0.05）。（4）HUTT阳性反应的处理：HUTT达到阳性诊断标准后，将诊断床放至平卧位，保持呼吸道通畅、鼻导管给氧、口服牛奶等，5 min 内心电图和血压均恢复正常。结论：6岁以下儿童行HUTT在临床上有一定实用价值，具有较好的安全性和依从性。

Application of the head-up tilt table test in children under 6 years old

Objective To study the clinical value and safety of the head-up tilt table test(HUTT) in children under 6 years old.Methods The HUTT results between September 2000 and August 2011 of 144 2 to 6-year-old children(81 boys and 63 girls) with syncope and dizziness of unknown causes were retrospectively studied.Results Eight children completed the based tilt table test and 136 cases completed the sublingual nitroglycerin tilt table test.No serious side effects were found in these children.Thirty-two(22.2%) of the 144 children had a positive result of HUTT,including 18 boys and 14 girls(P>0.05).When HUTT-induced syncope met positive standards,ECG record and blood pressure recovered to normal levels within 5 minutes by changing the position of the test bed,keeping the airway open,nasal oxygen inhalation and oral milk.Conclusions The HUTT is valuable,safe and compliant in children under 6 years old.