Stocker F, Wyler F
Kinderkardiologische Abteilungen, Universität-Kinderkliniken Bern und Basel.
Ther Umsch. 1994 Sep;51(9):601-6.
Emergencies in pediatric cardiology are heart failure, cyanosis and rhythm disturbances. The signs of heart failure are tachycardia, tachypnea and hepatomegaly. The therapy consists of oxygen, diuretics and digoxin. Occasionally, intubation with mechanical ventilation and intravenous catecholamines are needed. Cyanosis is often the only sign of a severe heart malformation, and prompt hospitalization is mandatory. Oxygen and warm environment is important during transport, correction of a possible metabolic acidosis and prostaglandin infusion are done in the hospital. Beyond the newborn period, so-called cyanotic spells are seen, particularly in tetralogy of Fallot. In supraventricular tachycardia, vagal manoeuvres can be tried first, if not successful, intravenous adenosine or electroconversion will restore sinus rhythm. In the older child, intravenous isoptin can be given. Slow heart rates from total AV block or sinus node affection are treated with atrophic, isuprel or electrical pacing.
小儿心脏病学中的急症包括心力衰竭、发绀和心律失常。心力衰竭的体征为心动过速、呼吸急促和肝肿大。治疗包括给氧、使用利尿剂和地高辛。偶尔需要进行气管插管并使用机械通气以及静脉注射儿茶酚胺。发绀常常是严重心脏畸形的唯一体征，必须立即住院治疗。转运期间给氧和保持温暖环境很重要，在医院要纠正可能存在的代谢性酸中毒并输注前列腺素。在新生儿期之后，会出现所谓的发绀发作，尤其是在法洛四联症中。对于室上性心动过速，可先尝试迷走神经手法，若不成功，静脉注射腺苷或进行电复律可恢复窦性心律。对于年龄较大的儿童，可静脉注射异搏定。完全性房室传导阻滞或窦房结病变导致的心率缓慢，可用阿托品、异丙肾上腺素治疗或进行电起搏。
