摘要
目的探讨急性肺栓塞患者心电图的变化特点。方法回顾性分析近3年收治的22例急性肺栓塞患者入院时、溶栓后及治疗2～4周后心电图的变化。结果入院时心电图变化：窦性心动过速18例（81．8％），右束传导支阻滞8例（36．4％），SⅠ〉0．1mV、SⅠQⅢTⅢ、QⅢ、TⅢ分别为15、14、17、10例（68．2％、63．6％、77．3％、45．5％）。胸前导联T波对称性倒置，V1～V6全部倒置2例（9．1％），V1～V4倒置8例（36．4％），V1～V2倒置12例（54．5％），伴有ST段压低7例（31．8％）；溶栓20～48h后心动过速明显缓解15例（68．2％），右束支阻滞消失5例（22．7％）。肢体导联出现SI变浅，QⅢ减小或消失，TⅢ倒置变浅或直立9例（40．9％）。胸前导联T波对称性倒置加深10例（45．5％）；2～4周后静息状态下心电图显示心动过速均消失，2例（9．1％）仍电轴右偏（〉＋90°）。胸前导联的T波直立数增加，ST段回到基线。肢体导联QⅢ进一步减小或消失，TⅢ倒置变浅或直立。胸前V1～V6导联T波均有不同程度的变浅或直立。结论心电图有助于急性肺栓塞的诊断，但急性肺栓塞心时电图变化多端，需动态观察并密切结合临床表现加以识别。
Objective To study the features of change of Electrocardiogram （ECG） in acute pulmonary embolism （APE）. Methods A retrospective analysis of ECG changes were done at the admission, post - thrombolysis and 2 -4 weeks after thrombolysis in 22 patients with acute pulmonary embolism over the past 3 years. Results In ECG of the patients with APE at the admission, there was tachycardia in 18 cases （81, 8% ） , right bundle branch block in 8cases （36.4%）, S Ⅰ 〉0. 1mV in 15 cases （68.2%） , SⅠ QⅢTⅢ pattern in 14 cases （63.6%） , QⅢpattem in 17 cases （77.3%） , TⅢ inversion in 10 cases （45.5%）, there is negative T wave in lead V1 -V6, V1-V4 and V1 -V2 in 2 （9. 1%）, 8 （36.4%） and 12 cases （54. 5 % ）, respectively with ST - segment depression in 7 cases （31.8%）. In post -thrombolytic ECG, tachycardla obviously reduced in 15 cases （68.2%）, right bundle branch block disappeared in 5 cases （22.7%）, SⅠ reduced, QⅢ decreased or disappeared and TⅢwave inversion got shallow or positive in 9 cases （40. 9% ） , T wave inversion in V1 - V6 became deeper in 10 cases （45, 5% ）. In ECG 2 -4 weeks after thrombolysis, tachycardia all disappeared, but there were 2 cases （9, 1% ） still with right axis deviation, the magnitude of negative T wave in V1 - V6 decreased or the T wave became positive, ST - segment depression went back to baseline. QⅢ decreased or disappeared further, TⅢ wave inversion became shallow or disappeared. Conclusion The ECG features in APE are changeable, which may be helpful in diagnosis of APE, and it should be dynamically observed, and closely associated with clinical manifestations.
出处
《中国全科医学》
CAS
CSCD
2006年第21期1803-1804,共2页
Chinese General Practice
关键词
急性肺栓塞
心电描记术
心电图特点
Acute pulmonary embolism
Electrocardiography
Characteristics of EGG
