Abstract: Dilated cardiomyopathy is a chronic heart disease characterized by left ventricular enlargement， systolic dysfunction， and high heterogeneity. When dilated cardiomyopathy progresses to the stage of refractory heart failure， patients' clinical symptoms significantly worsen and are accompanied by intolerance to medication. At this point， traditional treatment methods often fail to achieve ideal therapeutic effects. The quality of life of these patients deteriorates rapidly， and the disease progresses swiftly. Without timely intervention， they may face life-threatening risks in a short period of time. For children with dilated cardiomyopathy， it is particularly important to promptly identify refractory cardiomyopathy and provide appropriate intervention measures. This article reviews the progress in the diagnosis and management of refractory heart failure in children with dilated cardiomyopathy.

Key words: dilated cardiomyopathy, refractory heart failure, diagnosis, treatment, child

摘要： 扩张型心肌病是一种以左心室扩大、收缩功能障碍以及高度异质性为特征的慢性心脏疾病。当扩张型心肌病进展至难治性心衰阶段时，患儿的临床症状会显著加重，并且伴随对药物治疗的不耐受性。此时，传统治疗方法往往难以取得理想的治疗效果。这部分患儿的生活质量会急剧下降，疾病进展迅速，如果不进行及时干预，可能在短时间内面临生命危险。对于扩张型心肌病患儿而言，及时识别难治性心肌病并给予正确的干预措施显得尤为重要。文章对儿童扩张型心肌病难治性心衰的诊断和处理进展进行了综述。

关键词: 扩张型心肌病, 难治性心衰, 诊断, 治疗, 儿童