以呕吐为突出表现的心肌损害、心肌炎患儿38例临床病例分析

王会玲，王江茹，周杏花

（渭南市临渭区妇幼保健计划生育服务中心，陕西 渭南，71400）

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摘要：

目的 对以呕吐为突出表现的心肌损害、心肌炎患儿38例临床病例进行分析，帮助提高临床诊疗质量。方法 对我院38例以呕吐为突出表现的心肌损害、心肌炎患儿的临床症状、体征，常规检查，生化化验检查及心电图检查，心脏B超检查，及治疗结果进行分析并总结。结果 38例中，有10例住院时除了呕吐明显，还伴有腹泻、腹胀等消化道感染表现；全部患儿住院时间7~15 d，平均住院10 d。痊愈出院10例，好转出院28例。定期门诊随诊观察3月至2年不等，皆完全恢复健康无后遗 症。结论 有呕吐症状的患儿心肌损害、心肌炎发生几率虽然不高，但临床医生需引起重视，减少误诊误治。

关键词：呕吐；心肌损害；心肌炎

中图分类号：R542.21文献标志码：A文章编号：2096-1413(2016)27-0012-03

Clinical analysis of 38 cases of myocardial injury and myocarditis performed mainly by vomiting
WANG Hui-ling, WANG Jiang-ru, ZHOU Xing-hua
(Maternal and Child Health Care and Family Planning Service Center in Linwei District, Weinan 714000, China)

ABSTRACT: Objective To analyze the clinical cases of 38 children with suspicious cardiac damage and viral myocarditis who prominently manifestations vomit, and to help improve the quality of clinical diagnosis and treatment. Methods Thirty-eight cases of children with myocardial damage and myocarditis in our hospital were selected, and their clinical symptoms, signs, routine examination, biochemical laboratory tests and ECG, cardiac B-ultrasound results were analyzed and summarized. Results Of 38 cases, 10 cases who manifested as vomiting meanwhile accompanied by the digestive tract infections such as diarrhea, abdominal distension, performance; All children hospitalized with 7~15 d, the average hospitalization was 10 d, 10 cases were cured, 28 cases were discharged from hospital. After 3 months to 2 years regular outpatient follow-up observation, all children were completely recovered without sequelae. Conclusion The incidence of myocardial damage in children with
vomiting is not high, but clinicians need to pay attention to reduce misdiagnosis and wrong treatment.
KEYWORDS: vomit; myocardial damage; myocarditis

参考文献：
[1] 北京儿童医院心内科.心肌损害诊疗暂行标准[EB],2014,3.
[2] 吴瑞萍,胡亚美,江载芳.诸福棠实用儿科学(下册)[M].6 版.北京:人 民卫生出版社,1996:1491-1497.
[3] 中华医学会儿科学分会心血管学组中华儿科杂志编辑委员会,吴铁吉.小儿病毒性心肌炎诊断标准[J].中华儿科杂志,2000,38(2):75.
[4] 王卫平.儿科学[M].8 版.北京:人民卫生出版社,2013:304.
[5] 郝英华,于金凤.小儿支原体肺炎并发心肌损害48例观察分析[J]. 齐齐哈尔医学院学报,2010,31(15):2410.
[6] 高运金,陈圣玺.小儿轮状病毒性肠炎肝功能和心肌酶谱检测的临床意义[J].实用临床医学.2014,15(4):80-82.