Objective To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD). Methods Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p(A-a) (O2)]after anesthesia (T1), after operation (T2), at admission to intensive care unit (T3) and before extubation (T4) and complication rate between 2 groups were compared. Results (1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ2=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P 0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ2=0.000, P>0.05). Conclusions Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate
{"title":"Clinical effect of right subaxillary small incision approach on children with congenital heart disease","authors":"Penggao Wang, Yu Zhang, Zhongjian Chen, Yazhou Cui, Wenbo Yu, Xiangyang Dong","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.011","url":null,"abstract":"Objective \u0000To analyze the clinical effect of right subaxillary small incision approach on children with congenital heart disease (CHD). \u0000 \u0000 \u0000Methods \u0000Eighty-six patients with CHD admitted to Henan Children′s Hospital from January 2015 to September 2017 were enrolled in this study.The patients were randomly divided into the control group and the observation group with 43 cases each group.The control group underwent sternal median incision, and the observation group underwent right subaxillary small incision.The total effective rate, incision satisfaction, general conditions of surgery (cardiopulmonary bypass time, operation time, aortic occlusion time, intraoperative blood loss), postoperative related conditions (thoracic drainage volume, postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, hospitalization expenses), Wong-Baker facial expression scale (FPS-R) score, as well as the respiratory function index including the levels of peak inspiratory pressure (PIP) and alveolar-arterial oxygen pressure difference [p(A-a) (O2)]after anesthesia (T1), after operation (T2), at admission to intensive care unit (T3) and before extubation (T4) and complication rate between 2 groups were compared. \u0000 \u0000 \u0000Results \u0000(1)The incision satisfaction in the observation group [90.70% (39/43 cases)] was higher than that in the control group [62.79% (27/43 cases)], and the difference was statistically significant (χ2=9.382, P=0.002). (2)There was no significant difference in the the extracorporeal circulation time, operation time and aortic block time between the two groups [observation group: (68.94±8.26) min, (2.33±0.21) h, (28.79±7.32) min; control group: (67.11±9.11) min, (2.25±0.31) h, (30.02±6.88) min] (P>0.05). (3)The intraoperative blood loss [(89.87±11.25) mL] in the observation group was less than that in the control group [(105.91±31.01) mL], which difference was statistically significant (t=3.189, P=0.002). (4)Also there was significant difference in postoperative monitoring time, postoperative assisted ventilation time, hospitalization time, thoracic drainage volume and hospitalization expenses between the two groups (the observation group: postoperative monitoring time (30.55±10.39) h, postoperative assisted ventilation time [(9.68±2.19) h, hospitalization time (9.61±2.17) d, thoracic drainage volume (90.36±26.14) mL, hospitalization expenses (36 956.15±1 097.84) yuan; the control group: (41.39±9.93) h, (12.72±3.81) h, (12.33±3.15) d, (163.24±29.36) mL and (45 271.97±1 134.55) yuan] (t=4.946, 4.536, 4.663, 12.157, 34.540, all P 0.05). There was no significant difference in the complication rate between the observation group [6.98% (3/43 cases)] and the control group [4.65% (2/43 cases)] (χ2=0.000, P>0.05). \u0000 \u0000 \u0000Conclusions \u0000Right subaxillary small incision approach does not affect the respiratory function of children with CHD, which can improve the satisfaction of incision, reduce the amount of blood loss, accelerate ","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"41-45"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46533483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.003
S. Pan
Pulmonary artery denervation (PADN) can block local sympathetic nerve of pulmonary artery, reduce the hemodynamic parameters of pulmonary arterial hypertension(PAH), attenuate pulmonary vascular remodeling, right ventricular hypertrophy and fibrosis, thus improving cardiac function.Early basic experiment has determined the position of sympathetic nerve of pulmonary artery in pulmonary endarterium and confirmed the safety and effectiveness of PADN in the animal model of PAH.PADN may play a role by inhibiting execssive activation of the sympathetic nervous system and renin-angiotension-aldosterone system.PADN has been applied to adult clinical research, and has achieved a good clinical effect.On this basis, the possibility of applying PADN to children′s PAH is being explored preliminarily. Key words: Pulmonary arterial hypertension; Pulmonary artery denervation; Autonomic nerve; Child
{"title":"Progress of pulmonary artery denervation in treatment of pulmonary arterial hypertension","authors":"S. Pan","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.003","url":null,"abstract":"Pulmonary artery denervation (PADN) can block local sympathetic nerve of pulmonary artery, reduce the hemodynamic parameters of pulmonary arterial hypertension(PAH), attenuate pulmonary vascular remodeling, right ventricular hypertrophy and fibrosis, thus improving cardiac function.Early basic experiment has determined the position of sympathetic nerve of pulmonary artery in pulmonary endarterium and confirmed the safety and effectiveness of PADN in the animal model of PAH.PADN may play a role by inhibiting execssive activation of the sympathetic nervous system and renin-angiotension-aldosterone system.PADN has been applied to adult clinical research, and has achieved a good clinical effect.On this basis, the possibility of applying PADN to children′s PAH is being explored preliminarily. \u0000 \u0000 \u0000Key words: \u0000Pulmonary arterial hypertension; Pulmonary artery denervation; Autonomic nerve; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"6-9"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46618452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.020
Kaiyan Song, S. Nie
Non-compaction of ventricular myocardium (NVM), a rare congenital and inherited cardiomyopathy, is characterized by prominent trabeculations and deep intertrabecular recesses in communication with the ventricular cavity.NVM has diverse clinical presentations without specificity, of which the major characteristics are cardiac insufficiency, arrhythmias and thrombosis.Echocardiography and cardiac magnetic resonance imaging are necessary technologies to diagnose NVM.Symptomatic therapy is the only choice for most patients.Furthermore, if medical treatment fails, the heart transplantation could be performed.As a whole, NVM has a high mortality and entirely different prognosis, however, the prognosis of asymptomatic patients is relatively good. Key words: Non-compaction of ventricular myocardium; Cardiac insufficiency; Arrhythmia; Thrombosis
{"title":"Non-compaction of ventricular myocardium in children","authors":"Kaiyan Song, S. Nie","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.020","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.020","url":null,"abstract":"Non-compaction of ventricular myocardium (NVM), a rare congenital and inherited cardiomyopathy, is characterized by prominent trabeculations and deep intertrabecular recesses in communication with the ventricular cavity.NVM has diverse clinical presentations without specificity, of which the major characteristics are cardiac insufficiency, arrhythmias and thrombosis.Echocardiography and cardiac magnetic resonance imaging are necessary technologies to diagnose NVM.Symptomatic therapy is the only choice for most patients.Furthermore, if medical treatment fails, the heart transplantation could be performed.As a whole, NVM has a high mortality and entirely different prognosis, however, the prognosis of asymptomatic patients is relatively good. \u0000 \u0000 \u0000Key words: \u0000Non-compaction of ventricular myocardium; Cardiac insufficiency; Arrhythmia; Thrombosis","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"70-73"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48914203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.005
M. Qian
Heart failure is a complex clinical syndrome characterized by the heart losing the function of effective blood-pumping and venous return, which will cause a series of symptoms, and its clinical manifestations vary with the age of children.The main causes of heart failure in children are congenital heart disease and cardiomyopathy.Drug therapy for heart failure in children has gained rapid progression recently with Sacubitril/valsartan being a typical one, which was approved by Food and Drug Administration (FDA) in October 2019 for its effective use in symptomatic left ventricular dysfunction in children aged 1 year and above, marking that the drug therapy for heart failure in children stands at a new starting point.Implantable cardioverter defibrillator and cardiac resynchronization therapy are applicable to some patients with indications.Mechanical circulatory support is essential in the treatment of patients with cardiopulmonary failure, including extracorporeal membrane oxygenation and ventricular assist device, which is used as an important transition of short-term circulatory assisted transplantation.Pediatric heart transplantation is a treatment option for end-stage heart failure. Key words: Heart failure; Congenital heart disease; Pediatric intensive care; Progress
{"title":"Progress in diagnosis and treatment of heart failure in children","authors":"M. Qian","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.005","url":null,"abstract":"Heart failure is a complex clinical syndrome characterized by the heart losing the function of effective blood-pumping and venous return, which will cause a series of symptoms, and its clinical manifestations vary with the age of children.The main causes of heart failure in children are congenital heart disease and cardiomyopathy.Drug therapy for heart failure in children has gained rapid progression recently with Sacubitril/valsartan being a typical one, which was approved by Food and Drug Administration (FDA) in October 2019 for its effective use in symptomatic left ventricular dysfunction in children aged 1 year and above, marking that the drug therapy for heart failure in children stands at a new starting point.Implantable cardioverter defibrillator and cardiac resynchronization therapy are applicable to some patients with indications.Mechanical circulatory support is essential in the treatment of patients with cardiopulmonary failure, including extracorporeal membrane oxygenation and ventricular assist device, which is used as an important transition of short-term circulatory assisted transplantation.Pediatric heart transplantation is a treatment option for end-stage heart failure. \u0000 \u0000 \u0000Key words: \u0000Heart failure; Congenital heart disease; Pediatric intensive care; Progress","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"14-18"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42452456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A case of type I mucopolysaccharide storage syndrome in children admitted to the Children's Hospital affiliated with Nanjing Medical University in January 2017 was analyzed and summarized based on the diagnosis, treatment, and prognosis of a child diagnosed with type I mucopolysaccharide storage syndrome due to cardiac enlargement. Relevant literature retrieved from the Chinese Journal Full Text Database, Wanfang Database, PubMed, and other libraries were used to analyze and summarize the diagnosis, treatment principles, and prognosis of type I mucopolysaccharide storage syndrome in children with cardiomyopathy. The child, aged 4 months and 7 days, was diagnosed with "cardiac enlargement" and had a clinical condition characterized by dense hair. After repeated respiratory infections and anti-inflammatory and cardiac strengthening treatments, the genetic results showed two heterozygous variants in the IDUA gene. They were considered to have type I mucopolysaccharide storage syndrome and cardiomyopathy. They were followed up until 11 months after birth and died due to infection after stem cell transplantation. Mucopolysaccharide storage syndrome type I is a rare disease with no specific treatment in the past. The current treatment methods include hematopoietic stem cell transplantation, enzyme replacement therapy, and gene therapy. But for mucopolysaccharide storage disease type I, early identification is more important to improve the prognosis of the disease.
{"title":"Case report of type I and cardiomyopathy in children with mucopolysaccharidosis and literature review","authors":"Han Zhang, Shiwei Yang","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.018","url":null,"abstract":"对2017年1月南京医科大学附属儿童医院收治的1例因心脏扩大就诊后检测发现黏多糖贮积症Ⅰ型患儿诊疗经过及预后情况进行整理，结合在中国期刊全文数据库、万方数据库、PubMed等图书馆检索到的相关文献，分析并总结儿童黏多糖贮积症I型并心肌病的诊治原则及预后。患儿，4个月7 d，因\"心脏扩大\"就诊，临床特殊有毛发浓密，反复呼吸道感染后经抗炎、强心等处理，基因结果提示IDUA基因出现2个杂合变异，考虑为黏多糖贮积症I型并心肌病，随访至出生后11个月患儿干细胞移植后因感染死亡。黏多糖贮积症I型为罕见病，既往无特异性治疗手段。目前治疗方法包括造血干细胞移植、酶替代疗法及基因治疗等。但对于黏多糖贮积症Ⅰ型更重要的是早期识别，以改善该病预后。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"64-65"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47203799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.013
Xiang Lei, Zhanrong Li, Yanping Liu
Objective To investigate the relationship between serum glutamate levels and severity of retinopathy of prematurity (ROP) in children and its impact on the prognosis. Methods A total of 92 children with ROP who were screened and treated at Henan Provincial Eye Hospital from June 2017 to June 2018 and 50 healthy preterm infants screened at Henan Provincial Eye Hospital were selected for clinical control study.Ninety-two children with ROP were divided into the mild ROP group and the severe ROP group according to the stage of lesions, and they were divided into the progressive group and the spontaneous regression group according to whether the disease was progressive.The severity of ROP and prognosis were analyzed by measuring serum glutamate levels in 1 week and 6 weeks after birth. Results The serum glutamate concentration in the severe ROP group was the highest in the first week after birth[(122.08±14.55) mmol/L] and in the 6th week after birth [(107.13±13.20) mmol/L], followed by the mild ROP group[(98.60±14.48) mmol/L, (85.41±14.49) mmol/L] separately, and the lowest in the control group[(68.52±7.69) mmol/L, (54.97±6.31) mmol/L] separately, and there were significant differences among the 3 groups (all P<0.05). Pearson correlation analysis showed that serum glutamate concentration was positively correlated with the severity of ROP at 1 week and 6 weeks after birth (r=0.869, 0.875, all P<0.05). The levels of serum glutamate at the first week after birth and at the 6th week after birth in the progressive group [(107.18±17.62) mmol/L, (92.94±16.21) mmol/L]were significantly higher than those in the spontaneous regression group[(131.53±10.22) mmol/L, (118.82±8.18) mmol/L], and there were significant differences between the 2 groups (all P<0.05). The area under the curve(AUC) values of serum glutamate concentration at 1 week after birth and 6 weeks after birth were 0.855 and 0.936, respectively, according to the receiver operating characteristic(ROC) curve, while the optimal critical values of serum glutamate concentration at 1 week and 6 weeks after birth were 117.83 mmol/L (sensitivity was 0.909, specificity was 0.728) and 106.69 ng/L (sensitivity was 1.000, specificity was 0.790), respectively. Conclusions The serum glutamate concentration was positively correlated with the severity of ROP infants in 1 week and 6 weeks after birth.The optimal threshold of serum glutamate concentration in 1 week and 6 weeks after birth was more sensitive and specific in predicting the progression of retinopathy, and had higher value in evaluating the prognosis of the infants. Key words: Retinopathy of prematurity; Glutamate; Progression; Prognosis
{"title":"Significance of serum glutamate acid levels in children with retinopathy of prematurity and its effect on prognosis","authors":"Xiang Lei, Zhanrong Li, Yanping Liu","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.013","url":null,"abstract":"Objective \u0000To investigate the relationship between serum glutamate levels and severity of retinopathy of prematurity (ROP) in children and its impact on the prognosis. \u0000 \u0000 \u0000Methods \u0000A total of 92 children with ROP who were screened and treated at Henan Provincial Eye Hospital from June 2017 to June 2018 and 50 healthy preterm infants screened at Henan Provincial Eye Hospital were selected for clinical control study.Ninety-two children with ROP were divided into the mild ROP group and the severe ROP group according to the stage of lesions, and they were divided into the progressive group and the spontaneous regression group according to whether the disease was progressive.The severity of ROP and prognosis were analyzed by measuring serum glutamate levels in 1 week and 6 weeks after birth. \u0000 \u0000 \u0000Results \u0000The serum glutamate concentration in the severe ROP group was the highest in the first week after birth[(122.08±14.55) mmol/L] and in the 6th week after birth [(107.13±13.20) mmol/L], followed by the mild ROP group[(98.60±14.48) mmol/L, (85.41±14.49) mmol/L] separately, and the lowest in the control group[(68.52±7.69) mmol/L, (54.97±6.31) mmol/L] separately, and there were significant differences among the 3 groups (all P<0.05). Pearson correlation analysis showed that serum glutamate concentration was positively correlated with the severity of ROP at 1 week and 6 weeks after birth (r=0.869, 0.875, all P<0.05). The levels of serum glutamate at the first week after birth and at the 6th week after birth in the progressive group [(107.18±17.62) mmol/L, (92.94±16.21) mmol/L]were significantly higher than those in the spontaneous regression group[(131.53±10.22) mmol/L, (118.82±8.18) mmol/L], and there were significant differences between the 2 groups (all P<0.05). The area under the curve(AUC) values of serum glutamate concentration at 1 week after birth and 6 weeks after birth were 0.855 and 0.936, respectively, according to the receiver operating characteristic(ROC) curve, while the optimal critical values of serum glutamate concentration at 1 week and 6 weeks after birth were 117.83 mmol/L (sensitivity was 0.909, specificity was 0.728) and 106.69 ng/L (sensitivity was 1.000, specificity was 0.790), respectively. \u0000 \u0000 \u0000Conclusions \u0000The serum glutamate concentration was positively correlated with the severity of ROP infants in 1 week and 6 weeks after birth.The optimal threshold of serum glutamate concentration in 1 week and 6 weeks after birth was more sensitive and specific in predicting the progression of retinopathy, and had higher value in evaluating the prognosis of the infants. \u0000 \u0000 \u0000Key words: \u0000Retinopathy of prematurity; Glutamate; Progression; Prognosis","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"50-53"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47610857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.004
Cong Liu, Lin Liu, S. Zeng
Implantable cardioverter defibrillator (ICD) plays an irreplaceable role in preventing sudden cardiac death.There has been a continuous increase in the implantation rate of ICD in children along with technologic improvement.However, the choice of indication, device and implantation approaches of ICD still faces great challenges due to the particularity of children.Related issues on the clinical application of ICD in children, including common diseases, indications and the clinical application of ICD, are reviewed in this paper. Key words: Cardiology; Sudden cardiac death; Implantable cardioverter defibrillator; Child
{"title":"Progress in application of implantable cardioverter defibrillators in children","authors":"Cong Liu, Lin Liu, S. Zeng","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.004","url":null,"abstract":"Implantable cardioverter defibrillator (ICD) plays an irreplaceable role in preventing sudden cardiac death.There has been a continuous increase in the implantation rate of ICD in children along with technologic improvement.However, the choice of indication, device and implantation approaches of ICD still faces great challenges due to the particularity of children.Related issues on the clinical application of ICD in children, including common diseases, indications and the clinical application of ICD, are reviewed in this paper. \u0000 \u0000 \u0000Key words: \u0000Cardiology; Sudden cardiac death; Implantable cardioverter defibrillator; Child","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"10-13"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49068568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.012
Y. Deng, W. Zhao, L. Fu, Jie Shen, Yi-wei Chen, W. Ji, D. Zhu, Fen Li
Objective To investigate the incidence and prognosis of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defects in pediatric patients as well as the risk factors of regurgitation occurrence or aggravation. Methods Clinical data of 1 108 patients who underwent percutaneous closure in Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiaotong University from January 2011 to January 2017 was analyzed retrospectively, and the prognosis and risk factors of postoperative tricuspid regurgitation and aggravation were also analyzed. Results Mild tricuspid regurgitation occurred in 24 cases after surgery with the incidence of 2.1%.Among 5 cases with mild or above preoperative tricuspid regurgitation, the regurgitation was alleviated after surgery in 4 cases.No severe tricuspid regurgitation requiring surgical intervention occurred in any patient during follow-up.Univariate analysis showed that intervention time (P<0.05) and residual shunt (P<0.05) were risk factors for mild or above tricuspid regurgitation after intervention.Binary regression analysis indicated that the size of the occluder (mm) (OR=1.48, 95%CI: 1.13-1.90) and residual shunt (OR=6.53, 95%CI: 1.69-25.30) were risk factors for tricuspid regurgitation after intervention (all P<0.05). Conclusions There is a certain incidence of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defects, but most tricuspid regurgitation do not need surgical intervention.The intervention time, size of occluder and residual shunt are risk factors of intraoperatively or postoperatively tricuspid regurgitation. Key words: Ventricular septal defects; Tricuspid regurgitation; Septal occlude device; Retrospective study
{"title":"Prognosis and risk factors of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defects in children","authors":"Y. Deng, W. Zhao, L. Fu, Jie Shen, Yi-wei Chen, W. Ji, D. Zhu, Fen Li","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.012","url":null,"abstract":"Objective \u0000To investigate the incidence and prognosis of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defects in pediatric patients as well as the risk factors of regurgitation occurrence or aggravation. \u0000 \u0000 \u0000Methods \u0000Clinical data of 1 108 patients who underwent percutaneous closure in Shanghai Children′s Medical Center, School of Medicine, Shanghai Jiaotong University from January 2011 to January 2017 was analyzed retrospectively, and the prognosis and risk factors of postoperative tricuspid regurgitation and aggravation were also analyzed. \u0000 \u0000 \u0000Results \u0000Mild tricuspid regurgitation occurred in 24 cases after surgery with the incidence of 2.1%.Among 5 cases with mild or above preoperative tricuspid regurgitation, the regurgitation was alleviated after surgery in 4 cases.No severe tricuspid regurgitation requiring surgical intervention occurred in any patient during follow-up.Univariate analysis showed that intervention time (P<0.05) and residual shunt (P<0.05) were risk factors for mild or above tricuspid regurgitation after intervention.Binary regression analysis indicated that the size of the occluder (mm) (OR=1.48, 95%CI: 1.13-1.90) and residual shunt (OR=6.53, 95%CI: 1.69-25.30) were risk factors for tricuspid regurgitation after intervention (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000There is a certain incidence of tricuspid regurgitation after transcatheter closure of perimembranous ventricular septal defects, but most tricuspid regurgitation do not need surgical intervention.The intervention time, size of occluder and residual shunt are risk factors of intraoperatively or postoperatively tricuspid regurgitation. \u0000 \u0000 \u0000Key words: \u0000Ventricular septal defects; Tricuspid regurgitation; Septal occlude device; Retrospective study","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"46-49"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48737096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-05DOI: 10.3760/CMA.J.ISSN.2095-428X.2020.01.019
K. Xiang, Haisong Bu, Jiarong Li
Congenital heart disease (CHD) is the most common congenital malformation disease in infants.With the rapid development of clinical treatment, the survival rate of children with CHD increased significantly.However, postoperative complications in children with CHD, including heart failure, heart arrythmia, pulmonary hypertension and brain cognitive dysfunction, are another challenge, among which, brain cognitive dysfunction has been gradually recognized and valued by scholars.At present, the effect of cardiopulmonary bypass on brain cognitive function of children with CHD has been studied by a variety of research methods, including molecular biological technique, magnetic resonance imaging technique, optical imaging technology, brain electrical activity monitoring technology and nervous development scale.Varying degrees of brain cognitive dysfunction will occur in children with CHD after heart surgery, which is closely associated with many factors such as systemic inflammatory response related to cardiopulmonary bypass, cerebral ischemia-reperfustion injury, the duration of cardiopulmonary bypass, aortic cross clamp time, deep hypothermia circulatory arrest time, dynamic changes of temperature, degree of hemodilution and blood gas management strategy.The influence of cardiopulmonary bypass on postoperative brain cognitive function in children with CHD is reviewed in this paper, in order to provide reference for clinical diagnosis and treatment, and to improve the prognosis of children with CHD. Key words: Cardiopulmonary bypass; Brain cognitive function; Congenital heart disease
{"title":"Influence of cardiopulmonary bypass on postoperative brain cognitive function of children with congenital heart disease","authors":"K. Xiang, Haisong Bu, Jiarong Li","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.019","url":null,"abstract":"Congenital heart disease (CHD) is the most common congenital malformation disease in infants.With the rapid development of clinical treatment, the survival rate of children with CHD increased significantly.However, postoperative complications in children with CHD, including heart failure, heart arrythmia, pulmonary hypertension and brain cognitive dysfunction, are another challenge, among which, brain cognitive dysfunction has been gradually recognized and valued by scholars.At present, the effect of cardiopulmonary bypass on brain cognitive function of children with CHD has been studied by a variety of research methods, including molecular biological technique, magnetic resonance imaging technique, optical imaging technology, brain electrical activity monitoring technology and nervous development scale.Varying degrees of brain cognitive dysfunction will occur in children with CHD after heart surgery, which is closely associated with many factors such as systemic inflammatory response related to cardiopulmonary bypass, cerebral ischemia-reperfustion injury, the duration of cardiopulmonary bypass, aortic cross clamp time, deep hypothermia circulatory arrest time, dynamic changes of temperature, degree of hemodilution and blood gas management strategy.The influence of cardiopulmonary bypass on postoperative brain cognitive function in children with CHD is reviewed in this paper, in order to provide reference for clinical diagnosis and treatment, and to improve the prognosis of children with CHD. \u0000 \u0000 \u0000Key words: \u0000Cardiopulmonary bypass; Brain cognitive function; Congenital heart disease","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"66-69"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44410667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To explore the clinical characteristics, pathogenesis, and prevention and treatment measures of rapid platelet reduction after percutaneous arterial catheter occlusion. Method: From January 2017 to December 2018, the Heart Center of Qingdao Women and Children's Hospital conducted a total of 121 cases of percutaneous arterial catheter occlusion surgery. Among them, 6 cases experienced rapid thrombocytopenia after surgery. The relevant clinical data were retrospectively analyzed, and the risk factors, clinical characteristics, possible mechanisms, and prevention and treatment measures for rapid thrombocytopenia were summarized. The occurrence time of thrombocytopenia in 6 children was 3-5 days after surgery, and the lowest value of thrombocytopenia was 19 × 109/L, platelet recovery time is 7 to 20 days after surgery. The diameter of the arterial catheter measured by angiography was 4.0-4.5 mm. Four cases used the 9-PDA-0810 occluder produced by AGA Company in the United States, and two cases used the 0810 PDA occluder produced by Shanghai Shape Memory Company. Bone marrow examination showed a decrease in the production of plate type megakaryocytes in the bone marrow of 3 children, and they recovered well after immunotherapy. All pediatric platelet counts returned to normal upon discharge. During a follow-up period of 6-14 months after discharge, all patients maintained normal platelet counts. Conclusion: After percutaneous arterial catheter occlusion, it is necessary to be vigilant for rapid platelet reduction, with no serious complications, a good prognosis, and possible involvement of immune mechanisms. Further research is needed.
{"title":"Clinical analysis of rapid thrombocytopenia after percutaneous transcatheter closure of arteries in children","authors":"Z. Ji, Na Liu, G. Luo, Zhen Bing","doi":"10.3760/CMA.J.ISSN.2095-428X.2020.01.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.2095-428X.2020.01.014","url":null,"abstract":"目的 \u0000探讨经皮动脉导管介入封堵术后血小板快速减少的临床特点、发病机制和防治措施。 \u0000 \u0000 \u0000方法 \u0000选择2017年1月至2018年12月青岛市妇女儿童医院心脏中心共实施经皮动脉导管介入封堵手术121例，其中6例术后发生血小板快速减少，回顾分析其相关临床资料，总结血小板快速减少发生的危险因素、临床特点、可能机制和防治措施。 \u0000 \u0000 \u0000结果 \u00006例患儿血小板减少发生时间为术后第3－5天，血小板下降最低值为19×109/L，血小板恢复时间为术后7～20 d。造影测量动脉导管内径为4.0～4.5 mm，4例选用美国AGA公司生产规格9-PDA-0810堵闭器，2例选用上海形状记忆公司生产规格0810PDA堵闭器。骨髓学检查提示3例患儿骨髓产板型巨核细胞减少，免疫治疗后恢复良好。所有患儿血小板计数在出院时恢复正常。出院随访6～14个月，所有患儿血小板计数维持正常。 \u0000 \u0000 \u0000结论 \u0000经皮动脉导管介入封堵术后需警惕血小板快速减少，多无严重并发症发生，预后良好，免疫机制可能参与其中，需进一步研究。","PeriodicalId":9843,"journal":{"name":"中华实用儿科临床杂志","volume":"35 1","pages":"54-56"},"PeriodicalIF":0.0,"publicationDate":"2020-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41715912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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