心电图在重度肺动脉瓣狭窄诊治中的价值  

Evaluation of Electrocardiogram in Diagnosis and Treatment of Severe Pulmonary Stenosis

作　　者：张海燕[1] 李筠[1] 朱敏[1] 邢海华[1] 王红平[1] 屈顺梅[1] 

机构地区：[1]上海交通大学医学院附属儿童医学中心心内科,上海200127

出　　处：《实用儿科临床杂志》2007年第1期41-42,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨心电图在重度肺动脉瓣狭窄(PS)诊治中的应用价值。方法结合心脏超声和心导管检查结果,对34例单纯性重度PS患儿(男21例,女13例;平均年龄3.5岁)经皮球囊肺动脉瓣成形术(PBPV)前后心电图进行分析;并与34例轻中度患儿心电图进行比较。结果单纯重度PS的心电图电轴极度右偏、P波及V1R波振幅增高,与轻中度PS比较存在显著差异(P<0.05);V1T波振幅与重度PS的右心室压力、跨肺动脉瓣压力阶差呈直线正相关(r=0.81,0.82Pa<0.05);PBPV不同疗效组间心电图比较无显著性差异(P>0.05);PBPV术后近期心电图随访显示,其在心电轴、V1R波的电压、V1T波异常方面均有显著好转(Pa<0·05)。结论心电图对PS严重程度具有一定的诊断价值;根据V1R波振幅可估测右心室压力和跨肺动脉瓣的压力阶差;心电图无法预测PBPV术的疗效,但对PBPV术后的随访有重要辅助作用。Objective To evaluate electrocardiogram（ECG） in the diagnosis and treatment of severe pulmonary stenosis（PS）. Methods Thirty - four patients （ 21 males, 13 females, average age of 3.5 years） with severe PS were included in this study. Their pre and post pereutaneous bolloon pulmonary valvularplasty（ PBPV ） ECG were analyzed, combined with the results of echo and catheterization. Results Axises were markedly dextrodeviated and voltage of P wave and V1R markedly increased, and there were significant differences compared with the mild and moderate PS groups（ P 〈0.05 ）. Pressure of right ventricle and the transpulmonary valvular gradient had good correlation with V1R voltage （ r = 0.81,0.82 all P 〈 0.05 ）. There were no significant differences in the different effects of PBPV （ P 〉 0.05 ）. With the early follow - up after PBPV, the abnormalities of axis, V1R voltage and V1T wave were improved markedly （ all P 〈0. 05 ）. Conclusions ECG can help us to assess the severity of PS. Right ventricle（RV） pressure and transpulmonary valvualr gradient can be estimated according to V1R voltage. Although ECG can＇t foreast the effect of PBPV ,it plays an important role in follow -up of the severe PS after PBPV.

关 键 词：心电描记术 肺动脉瓣狭窄 经皮球囊肺动脉瓣成形术 儿童 

分 类 号：R725.4[医药卫生—儿科]