中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2008年
4期
344-345
,共2页
王卫忠%陈熙%田科%刘昭红
王衛忠%陳熙%田科%劉昭紅
왕위충%진희%전과%류소홍
肺栓塞%心电图%诊断
肺栓塞%心電圖%診斷
폐전새%심전도%진단
Pulmonary embolism%Electrocardiography%Diagnesis
目的 评估心电图对急性肺动脉栓塞(肺栓塞)的诊断价值.方法 回顾性分析43例既往无心肺疾病的急性肺栓塞患者住院首次、溶栓后及出院前系列心电图变化.结果 ①入院时首次心电图:心动过速26例(60.47%),右束支传导阻滞10例(23.26%);V1导联和V1～V2导联、V1～V3导联、V1～V4导联、V1～V5导联、V1～v6导联T波倒置分别为34例(79.70%)、20例(46.52%)、12例(27.91%)、9例(20.93%)、7例(16.28%)和2例(4.65%);SⅠ＞0.1 mV、TⅢ倒置、QⅢ和SⅠQⅢTⅢ分别为23例(53.49%)、21例(48.84%)、27例(62.79%)和20例(46.52%).②溶栓后心电图:心动过速消失20例(76.9%),右束支传导阻滞消失4例(40%),胸前导联T波倒置加深4例,SⅠ变浅、QⅢ减小或消失、TⅢ倒置变浅或直立11例.③出院前心电图:心动过速消失;胸前导联T波直立数增加,ST段回基线,QⅢ进一步减小或消失,TⅢ倒置变浅或直立.结论 急性肺栓塞心电图变化多变,需动态观察并密切结合临床加以识别.
目的 評估心電圖對急性肺動脈栓塞(肺栓塞)的診斷價值.方法 迴顧性分析43例既往無心肺疾病的急性肺栓塞患者住院首次、溶栓後及齣院前繫列心電圖變化.結果 ①入院時首次心電圖:心動過速26例(60.47%),右束支傳導阻滯10例(23.26%);V1導聯和V1～V2導聯、V1～V3導聯、V1～V4導聯、V1～V5導聯、V1～v6導聯T波倒置分彆為34例(79.70%)、20例(46.52%)、12例(27.91%)、9例(20.93%)、7例(16.28%)和2例(4.65%);SⅠ＞0.1 mV、TⅢ倒置、QⅢ和SⅠQⅢTⅢ分彆為23例(53.49%)、21例(48.84%)、27例(62.79%)和20例(46.52%).②溶栓後心電圖:心動過速消失20例(76.9%),右束支傳導阻滯消失4例(40%),胸前導聯T波倒置加深4例,SⅠ變淺、QⅢ減小或消失、TⅢ倒置變淺或直立11例.③齣院前心電圖:心動過速消失;胸前導聯T波直立數增加,ST段迴基線,QⅢ進一步減小或消失,TⅢ倒置變淺或直立.結論 急性肺栓塞心電圖變化多變,需動態觀察併密切結閤臨床加以識彆.
목적 평고심전도대급성폐동맥전새(폐전새)적진단개치.방법 회고성분석43례기왕무심폐질병적급성폐전새환자주원수차、용전후급출원전계렬심전도변화.결과 ①입원시수차심전도:심동과속26례(60.47%),우속지전도조체10례(23.26%);V1도련화V1～V2도련、V1～V3도련、V1～V4도련、V1～V5도련、V1～v6도련T파도치분별위34례(79.70%)、20례(46.52%)、12례(27.91%)、9례(20.93%)、7례(16.28%)화2례(4.65%);SⅠ＞0.1 mV、TⅢ도치、QⅢ화SⅠQⅢTⅢ분별위23례(53.49%)、21례(48.84%)、27례(62.79%)화20례(46.52%).②용전후심전도:심동과속소실20례(76.9%),우속지전도조체소실4례(40%),흉전도련T파도치가심4례,SⅠ변천、QⅢ감소혹소실、TⅢ도치변천혹직립11례.③출원전심전도:심동과속소실;흉전도련T파직립수증가,ST단회기선,QⅢ진일보감소혹소실,TⅢ도치변천혹직립.결론 급성폐전새심전도변화다변,수동태관찰병밀절결합림상가이식별.
Objective To evaluate the diagnostic value of ECG in acute pulmonary thromboembolism.Methods ECG changes on admission,postthrombolysis and predischarge were retrospectively analyzed in 43 patients with acute pulmonary embolism(APE).Results ①The ECG changes of acute pulmonary embolism were tachyeardia in 26 cases(60.47%)and right bundle branch block in 10 cases(23.26%).The negative T wave in lead V1,V1～V2,V1～V3,V1～V4,V1～V5,and V1～V6 were seen in 34(79.70%),20(46.52%).12(27.91%),9(20.93%),7(16.28%),and 2 case(4.65%),respectively.S1＞0.1mV were seen in 23 cases (53.49%),TⅢ inversion in 21 cases(48.84%),QⅢ pattern in 27 cases(62.79%),SⅠQⅡTⅢ pattern in 20 cases (46.52);②Postthrombolytie ECG changes were:tachycardia disappeared in 20 cases,right bundle branch block disappeared in 4 case,T wave inversion in V1～V5 became deeper in 13 cases,SⅠ reduced,TⅢ wave inversion shallowed,QⅢ decreased or disappeared in 11 cases;③Predischarge ECG changes were:tachyeardia disappeared,the magnitude of negative T wave in V1～V5 was decreased,ST-segment depression went back to baseline,QⅢ decreased or disappered,TⅢ wave inversion shallowed or disappeared.Conclusion There are various abnormalities on the ECG observed in the patient with pulmonary embolism.It must be noted that pulmonary embolism cannot be precisely diagnosed solely on the basis of ECG changes.It is of great importance to observe the dynamic ECG changes and combined closely with clinical findings.
