Vereckei法新四步流程图对宽QRS心动过速鉴别诊断  

Vereckei's new approach for differential diagnosis of wide QRS complex tachycardia

作　　者：沈毅[1] 赵淑艳 李虹伟[1] 郑平渝[1] 顾复生[1] 李莉[1] 

机构地区：[1]首都医科大学附属北京友谊医院心脏中心,北京100050 [2]河北省大厂人民医院功能科,河北大厂065300

出　　处：《临床和实验医学杂志》2008年第7期21-23,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的了解宽QRS心动过速(WQRST)的鉴别诊断依据。方法选择在运动试验过程中诱发WQRST27例,根据Vereckei法新四步流程图,回顾性分析室性心动过速(VT)和室上性心动过速(SVT)的发病率。结果Vereckei法鉴别诊断WQRST符合率92.6%,误诊率7.4%。其中4例缺血性VT和1例缺血性SVT伴束支传导阻滞的高危患者,均经积极救治(急诊PCI)痊愈出院。结论Vereckei新四步法是WQRST鉴别诊断的重要手段之一,有助于及时正确识别VT和SVT,对疾病的治疗和预后有积极的作用。Objective To understand the basis of Vereckei is new algorithm in differential diagnosis of wide QRS complex tachycardia （ WQRST）. Methods The data of electrocardiogram treadmill exercise test（ETI＇） induced WQRST in 27 patients were retrospectively analyzed on the basis of Vereckei＇s new four stepwise approach for the incidence of ventriculur tachycardia（VT） and supraventriculur tachycardia（SVT）. Resuits The rate for correct diagnosis of new four consecutive steps was 92.6% and misdiagnosis in 7.4%. Among high risk patients, 4 cases of ischemic VT and 1 cases of ischemic SVT with bundle branch block received timely treatment with percutaneous coronary intervention and they were discharged from the hospital with favourable recovery. Conclusion Vereckei＇s new four stepwise criterion is a very important measure in differenti- ation of WQRST. Thus it may help to accurately distinguish VT from SVT in time. This new approach plays an important role in treatment and prognosis of the disease.

关 键 词：运动试验 宽QRS心动过速 心电图 鉴别诊断 方法 

分 类 号：R541.7[医药卫生—心血管疾病]