6岁以下儿童直立倾斜试验探讨

Application of the head-up tilt table test in children under 6 years old

摘要:

目的：探讨6岁以下儿童直立倾斜试验（HUTT）的临床价值和安全性。方法：对2000年9月至2011年8月对144例因不明原因晕厥、头晕等症状就诊的儿童（年龄2～6岁，男81例，女63例）的HUTT结果进行回顾性分析。结果：（1）HUTT依从性：144例受试儿童中8例仅完成了基础直立倾斜试验，136例完成了舌下含服硝酸甘油倾斜试验。（2）HUTT安全性：受试儿童完成HUTT后均未出现严重副反应。（3）HUTT阳性率：HUTT阳性率为22.2%（32/144），男童（18例）与女童（14例）阳性率差异无统计学意义（P>0.05）。（4）HUTT阳性反应的处理：HUTT达到阳性诊断标准后，将诊断床放至平卧位，保持呼吸道通畅、鼻导管给氧、口服牛奶等，5 min 内心电图和血压均恢复正常。结论：6岁以下儿童行HUTT在临床上有一定实用价值，具有较好的安全性和依从性。

Abstract:

OBJECTIVE: To study the clinical value and safety of the head-up tilt table test (HUTT) in children under 6 years old. METHODS: The HUTT results between September 2000 and August 2011 of 144 2 to 6-year-old children (81 boys and 63 girls) with syncope and dizziness of unknown causes were retrospectively studied. RESULTS: Eight children completed the based tilt table test and 136 cases completed the sublingual nitroglycerin tilt table test. No serious side effects were found in these children. Thirty-two (22.2%) of the 144 children had a positive result of HUTT, including 18 boys and 14 girls (P>0.05). When HUTT-induced syncope met positive standards, ECG record and blood pressure recovered to normal levels within 5 minutes by changing the position of the test bed, keeping the airway open, nasal oxygen inhalation and oral milk. CONCLUSIONS: The HUTT is valuable, safe and compliant in children under 6 years old.