脑损伤患者动态心电异常的临床观察  

Changes of dynamic electrocardiogram in patients with brain injury

作　　者：郭彩霞[1] 杜凤和[1] 徐晓微[1] 

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100050

出　　处：《心血管康复医学杂志》2008年第2期177-180,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：国家自然科学基金(30740054);首都医学发展科研基金(2002-2025)

摘　　要：目的:观察脑损伤患者的动态心电图改变,了解急性脑损伤致心电异常的特点及其与损伤部位和严重程度的关系。方法:选取我院急性脑损伤患者56例,经Glasgow评分分型,脑CT确定损伤部位,并行24h动态心电图检查,观察急性脑损伤后心电异常的发生情况,并根据脑损伤部位和严重程度分组观察,以了解其心电异常的特点。结果:急性脑损伤患者心电异常发生率为57.14%,其中50%患者出现ST-T异常。急性脑损伤后血肿部位和严重程度不同,心电异常的发生特点也不同,按部位分脑内血肿心电异常率最高,达71.43%,按Glasgow评分重型脑损伤心电异常率最高,达73.08%(P均<0.05)。结论:急性脑损伤患者心电异常表现为心律失常和ST-T异常,且与脑损伤部位和严重程度有关。Objective.. To study the changes of dynamic electrocardiogram in patients with brain injury. Methods： Fifty-six patients with acute brain injury were recruited in this study. The Glasgow coma scale, the initial computed tomogram and ambulatory electrocardiogram were performed in all subject. Data were analyzed according to different place and severity of brain injury. Results： ECG abnormalities were found in 32 patients out of 56 patients with acute head injury （57.14%） . ST-T abnormities were found in half of the brain injury patients. Sinus tachycardia, fre-quent atrial premature beats, atrial tachycardia and ventricular tachycardia were recorded among arrhythmias. ECG abnormalities were present in 71.43% of patients with intracerebral haematoma, 66.67% of patients with subdural haematoma and 36.84% of patients with extradural haematoma （P〈0.05 all）. The brain injury divided into severe, moderate and mild degree according Glasgow coma scale. ECG abnormalities were present in 73. 080/00 of severe patients, 63.64% of moderate patients and 36.84% of mild patients with acute brain injury （P〈0.05 all）. Conclusion： Acute brain injury can lead to arrhythmia and ST-T abnormalities. ECG abnormalities are associated with place and severity of brain injury.

关 键 词：脑损伤 心电描记术 便携式 心律失常 

分 类 号：R395.1[哲学宗教—心理学] R768.1[医药卫生—医学心理学]