小儿阵发性室上性心动过速药物干预的临床研究

目的：对比研究和评价静脉药物终止小儿阵发性室上性心动过速（PSVT）的疗效、起效时间、不良反应．以指导临床小儿PSVT的药物复律，提高复律成功率，减少不良反应。方法：收集7年来我院住院患儿中，经腺苷三磷酸（ATP）、心律平、西地兰治疗的PSVT病人共58例，比较各种药物的复律时间、成功率覆不盘反应。结果：ATP复律时间3～30s，成功率为86．67％．不盘反应发生率63．33％；心律平复律时间5—30min，成功率73．68％，不盘反应发生率15．78％；西地兰复律时间20min-5h．成功率59．09％，不良反应发生率4．54％。结论：对无明显器质性心脏病和严重并发症的小儿PSVT，复律应首选ATP，虽然不良反应发生率高，但程度较轻且消失快；心律平疗效好且不盘反应少，与ATP一样．可作为一线药，合并预激综合征者尤其应首选心律平：合并明显心力衰竭者首选西地兰。

Clinical study of drugs interference in children with paroxysmal supraventricular tachycardia

Objective: To compare and assess the curative effects, starting time and side effects of cardioversion drugs used in treatment of paroxysmal supraventricular tachycardia (PSVT), including adenosine triphosphate (ATP), propafenone, and cedilanid. Methods: The data of 58 admitted children with PSVT who were treated with ATP, dofetilide and cedilanid in recent 7 years were collected. The cardioversion time, success rate and side effects of the drugs were compared. Results: In group ATP, 86.67% of patients were interrupted; 63.33% of them had side effects; the cardioversion time of ATP was 3 ~ 30 se. In group propafenone, 73.68% of the patients were interrupted, 15.78% of them had side effects; the cardioversion time of propafenone was 5 ~ 30 min. In group cedilanid, 59.09% of the patients were interrupted, 4.54% of them had side effects; the cardioversion time of cedilanid was 20 min ~ 5 h. Conclusions: ATP should be considered the drug of first choice for PSVT in children without organic heart diseases and serious complication and it has only minor and transient side effects. Propafenone is equally effective in interrupting PSVT, and has minor side effects, which should be considered the first choice and best suitable for atrioventricular reentrant tachycardia. Cedilanid should be considered the drug of first choice for PSVT in children with serious heart failure.