Clinical Analysis Of 15 Cases Of Fulminant Myocarditis In Children

Objective: Summarize the clinical characteristics and treatment of fulminant myocarditis in children,improve the diagnosis and treatment of the disease,and achieve early identification and reduce the mortality rate.Method:The clinical data of 15 cases of fulminant myocarditis in children admitted to the Second Hospital of Hebei Medical University from June 2008 to February 2019 were collected and analyzedResults:There were 15 cases of fulminant myocarditis in this group,ranging from 8 months to 13 years old,including 6 males and 9 females.The clinical manifestations were diverse,including 6 cases of circulatory system(40.0%).The main symptoms were chest pain,chest tightness,palpitation,and 4 cases of respiratory system(26.6).The main symptoms were fever,cough,shortness of breath,hernia,and 3 cases of digestive system(20.0%).The main symptoms are vomiting,pain under the xiphoid,and 2 cases of the nervous system(16.6%).The main symptoms are convulsions and headache.15 patients in this group had different degrees of cardiac dysfunction symptoms and signs,including 3 cases of cardiogenic shock(CGS)(20.0%),1 case of Assy syndrome(6.6%).Electrocardiogram(ECG)showed that 13 patients in this group showed conduction block and 10 patients had ST-T changes(60.6%).3 patients had ventricular premature beats(20.0%),2 patients had ventricular tachycardia(13.3%),3 patients with echocardiography had left ventricular enlargement(25.0%),and 3 patients had right ventricular enlargement(25.0%).3 cases of wall thickening(25.0%),3 cases of left ventricular systolic function decreased(25.0%),1 case of whole heart enlargement(6.6%),15 cases of myocardial enzymology examination,14 cases of increased,this group Nine patients in the case had serum troponin I(Cardiac troponin I CTnI),of which 8 had increased troponin(88.8%).In this group of patients,6 cases of children with B natriuretic peptide(BNP)were increased.Five patients in this group had viral antibody tests,one of which detected Coxsackie virus A group,one case of Coxsackie virus B group,one case of herpes simplex virus,and two cases of negative.Treatment is given to ECG monitoring,oxygen,sedation,bed rest,etc.,given large doses of vitamin C,phosphate creatine and other nutrient myocardium,ganciclovir,ribavirin and other antiviral,high dose methylprednisolone succinate Sodium,intravenous immunoglobulin inhibits inflammation and cardiomyocyte edema,milrinone,diuretics,vasodilators,etc.improve heart function,children with physical manifestation are given expansion,dopamine and dobutamine to correct heart Sexual body grams.In this group,15 cases of fulminant myocarditis in children were improved after rescue and comprehensive treatment,10 cases died,4 cases died,and 1 case was transferred.Conclusion:The onset of fulminant myocarditis in children is rapid,rapid progress,high mortality,diagnosis should be combined with clinical manifestations,symptoms,signs and objective biochemical indicators such as ECG,myocardial markers,etc.,in order to achieve early diagnosis,treatment is still symptomatic treatment Mainly,actively correcting heart failure,CGS,and timely installation of temporary pacemakers are also important treatments.