摘要
目的探讨心电图在诊治急性肺栓塞中的作用。方法回顾性分析38例确诊的急性肺栓塞患者入院时及溶栓后1周的心电图变化。结果入院时SI>0.1mV者32例次(84.21%),SIQⅢTⅢ型23例次(60.53%),QⅢTⅢ型21例次(55.26%),TⅢ倒置29例次(76.32%),TV1～V2倒置26例次(68.42%),TV1～V3倒置l9例次(50.0%),TV1～V4倒置15例次(39.47%),TV1～V5倒置4例次(10.53%)。T波倒置均呈对称性,不完全性右束支传导阻滞7例次,SV1-V5R粗钝、挫折l7例次(44.74%)。溶栓后1周SI>0.1mV、SIQⅢTⅢ型、QⅢTⅢ型、顺钟向转位、电轴右偏、窦性心动过速、房性心律失常及aVR终末R波等指标阳性率均有减少,差异均有显著性意义(P<0.05)。溶栓后胸导联T波倒置较溶栓前大多加深。结论急性肺栓塞心电图改变是非特异性的,但如能紧密结合临床、动态观察心电图改变,则有助于诊断急性肺栓塞。有效溶栓治疗后胸导联T波倒置加深可能是右心室负荷减轻的一种表现。
Objective To evaluate clinical value of ECG in diagnosis and treatment of acute pulmonary embolism（APE）. Methods ECGs recorded in admission and one week after thrombolysis in 38 patients with APE were analyzed retrospectively. Results Main manifestations of ECG in admission were：S1〉0.1 mV in 32 eases（84.21%）, S1QⅢTⅢ pattern in 23 cases（60.53%）, QⅢTⅢa pattern in 21 cases （55.26%）, TⅢ inversion in 29 cases （76.32%）, T waves inversion in V1-2 in 26 cases （68.42%）,T waves inversion in V1-3 in 19 cases （50.0%）. T wave inversion was symmetrical. One week after thrombolysis, number of cases with S1〉0.1mV, SIQⅢTⅢ pattern and QⅢTⅢn pattern on ECG was significantly reduced when compared to that before thrombolysis（all P〈0.05） and T wave inversion in precordial leads deepened in most cases. Conclusion Although ECG manifestations of APE arc non-specific, their dynamic changes combined with clinical data may be useful in diagnosis and treatment of APE.
出处
《心电学杂志》
2006年第2期82-84,共3页
Journal of Electrocardiology(China)
关键词
肺栓塞
心电图
T波
倒置加深
Pulmonary embolism, Electrocardiography, T waves, Deeped inversion
