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目的通过对13例急性重症病毒性心肌炎患者临床资料的分析,总结急性重症心肌炎的临床表现特点及治疗转归,提高对急性重症病毒性心肌炎的认识和诊治水平。方法对13例临床诊断为急性重症病毒性心肌炎的临床资料进行回顾性分析。结果 13例患者中男性7例,女性6例;其中7例出现急性左心衰,6例出现心源性休克,3例出现阿-斯综合征,5例出现Ⅲ度房室传导阻滞,7例出现急性肾功能不全;治愈8例,好转4例,死亡1例。结论急性重症病毒性心肌炎临床表现复杂多样且病情进展快,病死率高,早期诊断和合理治疗能提高抢救成功率;早期静脉应用大剂量维生素C、黄芪注射液、抗病毒和静脉丙球治疗有良效;同时积极治疗危重并发症能改善患者预后。
Objective To analyze the clinical data of 13 patients with acute severe viral myocarditis and summarize the clinical manifestations and treatment outcome of acute severe myocarditis and to improve the understanding and diagnosis and treatment of acute severe viral myocarditis. Methods The clinical data of 13 cases diagnosed as acute severe viral myocarditis were retrospectively analyzed. Results There were 7 males and 6 females in 13 cases. Among them, 7 cases had acute left heart failure, 6 cases had cardiogenic shock, 3 cases had Asperger’s syndrome, 5 cases had Ⅲ degree atrioventricular block, 7 cases of acute renal failure; cured in 8 cases, improved in 4 cases, 1 died. Conclusions The clinical manifestations of acute severe viral myocarditis are complex and diverse, the disease progresses rapidly and the mortality rate is high. Early diagnosis and reasonable treatment can improve the success rate of rescue. Early intravenous administration of high-dose vitamin C, astragalus injection, antiviral and intravenous corticosteroids Good effect; active treatment of critically ill complications can improve the prognosis of patients.