急性重症病毒性心肌炎20例诊治体会

目的 总结急性重症病毒性心肌炎的诊治经验.方法 对20例急性重症心肌炎患者的诊治资料进行回顾性分析.结果 患者均进行心电图、心脏超声和心肌酶学、钙蛋白等心肌损伤标记物检查.在常规支持治疗的基础上,根据患者病情给予纠正心力衰竭、减慢心率或床旁置入临时心脏起搏器治疗.治疗2周后,8例患者临床治愈,5例好转,4例有不同程度的心功能不全,3例死亡.结论 急性重症病毒性心肌炎可根据病毒感染史、临床表现、心肌损伤标志物的升高、超声发现心脏增大和普遍活性减弱、心电图异常等,并排除其他继发性心肌病而诊断.治疗方法包括休息、综合监护、营养及改善心肌细胞代谢和纠正心力衰竭、心律失常等.

Experience of Diagnosis and Therapy of Fulminant Myocarditis

Objective To summarize the experience of diagonosis and therapy of fulminant myocarditis.Methods 20 patients with fulminant myocarditis were reviewed.Results All the patients underwent a clinical examination including echocardiography,ultrasonic doppler,serum creatine kinase.On the basis of tranditional treatment,supporting methods were given,such as rectifing the heart failure,reducing the heart rate and so on.After two weeks of therapy,8 patients healed,5 improved,4 with cardiac functional insufficiency,3 died.Conclusion Patients with fulminant myocarditis can be diagnosed according to the history of viruses infection,clinical manifestation,the high level of myocardial injury marker,cardiac enlargement by ultrasonic doppler and abnormal ECG.The treatment includes relaxing,monitoring,nutrition,improving the metabolism of cardiomyocytes,correcting the heart failure and arrhythmia etc.