关键词: 晕厥, 血管迷走神经性；口服补液盐；美托洛尔；盐酸米多君；儿童

Abstract:

To explore the individualized treatment for vasovagal syncope （VVS） in children with different hemodynamic patterns.Methods　A total of 63 children aged 6～19 years ［mean age （11.57±2.89） years］ with VVS were followed up in clinics or by telephone.Totally 32 cases were diagnosed as VVS vasodepressor type，31 cases were diagnosed as VVS mixed type or cardioinhibitory type. Fourteen cases took oral rehydration salts，13 cases took metoprolol and 36 cases took midodrine hydrochloride as initial treatment. Patients were followed up for 3～48 months，with a mean of （21±12） months. The recurrence of syncope in 3 months was studied to evaluate short-term efficacy of 3 different therapies. Taking recurrence of syncope as  ents，Kaplan-Meier curves were drawn to compare long-term efficacy of different therapies in treating VVS children. Results　There was no statistical difference for the short-term efficacy among the diffrent hemodynemic patterns when treated with oral rehydration salts，or metoprolol or midodrine hydrochloride （oral rehydration：χ2＝ 0.498，P > 0.05；metoprol：χ2＝ 0.627，P > 0.05；midodrine hydrochloride：χ2＝ 2.057，P > 0.05）. There was no statistical difference for the long-term efficacy among VVS children with different hemodynamic patterns when treated with oral rehydration salts，or metoprolol. Patients with mixed or cardioin hibitory patterns had a better response than those with vasodepressor pattern to midodrine hydrochloride（P < 0.01） Conclusions Oral rehydration salts，metoprolol or midodrine hydrochloride are appropriate to treat children with VVS. Children with VVS mixed and cardioinhibitory patterns are more appropriate to take midodrine hydrochloride as initial treatment.

Key words: syncope vasovagal, oral rehydration salts, metoprolol, midodrine hydrochloride, children