[停止经口喂养是否会增加接受双苯甲胺治疗的早产儿发生房室传导阻滞的风险？]
[Does stopping of oral feeding favour the occurrence of auriculoventricular block in premature infants treated with diphemanil?].
作者信息
Guérois M, Favre A, Gold F, Blond M H, Chantepie A, Rondeau C, Ramponi N, Autret E
机构信息
Service de médecine néonatale, centre de pédiatrie Gatien-de-Clocheville, Tours, France.
出版信息
Arch Pediatr. 1997 Feb;4(2):158-62. doi: 10.1016/s0929-693x(97)86162-3.
BACKGROUND
Bradycardia in preterm infants may require anticholinergic therapy (diphemanil methylsulphate). Such treatment may cause prolongation of QT interval and auriculoventricular block.
CASE REPORTS
Three premature infants born before 34 weeks of gestational age were given 6-8 mg/kg/d diphemanil because they suffered from bradycardiac episodes. Aggravation and/or persistence of bradycardia required withdrawal of gavage feeding: heart block occurred within a few hours which subsided after cessation of diphemanil and oral refeeding. Diphemanil at progressive dosage was later introduced safely in two of these infants.
CONCLUSION
The short interval of time between the oral feeding withdrawal and occurrence of heart block justified therapy be stopped or transiently reduced whenever oral feeding must be interrupted.
背景
早产儿心动过缓可能需要抗胆碱能治疗（甲硫酸二苯马尼）。此类治疗可能导致QT间期延长和房室传导阻滞。
病例报告
3名孕龄小于34周的早产儿因心动过缓发作接受6 - 8毫克/千克/天的甲硫酸二苯马尼治疗。心动过缓加重和/或持续存在需要停止鼻饲喂养：数小时内发生心脏传导阻滞，在停用甲硫酸二苯马尼并恢复经口喂养后缓解。后来，其中2名婴儿安全地重新开始逐渐增加剂量的甲硫酸二苯马尼治疗。
结论
停止经口喂养与发生心脏传导阻滞之间的时间间隔较短，这证明每当必须中断经口喂养时，应停止治疗或暂时减少剂量。
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