胸部恶性肿瘤放射治疗后心电图异常的临床观察  

Abnormal ECG after radiotherapy in thoracic malignant tumors

作　　者：郑悦海[1,2] 方红[1,2] 郑作深[1,2] 

机构地区：[1]中山大学附属江门医院 [2]江门市中心医院,广东江门529070

出　　处：《基层医学论坛》2010年第4期109-111,共3页The Medical Forum

摘　　要：目的探讨胸部放射治疗对心脏的影响。方法对2005年1月—2007年12月收治的胸部恶性肿瘤88例患者在放疗前、放疗中和放疗后分别做心电图检查。左肺癌76例,右肺癌4例,其他肿瘤8例。常规放疗73例,大面积不规则野15例。<55Gy27例,≥55Gy61例。结果本组心电图异常发生率为43.2%(38/88),其中心动过速27.3%,心动过缓4.5%,ST段下移6.8%,传导阻滞4.5%.左下肺癌心电图异常率远远高于其他胸部肿瘤(P<0.01);≥55Gy组高于<55Gy组(P<0.05)。结论放射治疗期间可发生急性放射性心脏损伤,其损伤程度与心脏受照体积、放射剂量有关。胸部肿瘤放疗尤其是左肺癌时应当慎重。Objective To investigate the influence radioatherapy on heart. Methods The ECG of 88 cases of malignant tumors from January 2005 to December 2007 were analysized retrospectively. All patients were given ECG examination at the beginning, midway and the end of radiotherapy. There were 76 cases of left lung cancer, 4 cases of right lung cancer, 8 cases of other tumors. Among them, 73 cases had been treated with routine field radiotherapy, 15 cases with irregular large field radiotherapy.The radiotherapy dose were under 55 Gy in 27 cases, above 55 Gy or equal in 61 cases. Results The total incidence of abnormal ECG was 43.2% （38/88）. Such as tachycardia 27.3% , bradycardia 4.5%, ST segment depression 6.8%, conduction block 4.5%. The incidence rate of abnormal ECG in the the paitents with left lower lung cancer was higher than in others （P〈0.01）, It was higher in the patients with radiotherapy dose more than 55 Gy compared with in those with lower （P〈0.05）. Conclusion During radiotherapy ,acute radiation heat injuries may happen. The degree of injuries is different depending on the area of the irradiation field, the dose of radiotherapy. The author suggest that radiation should be cautiouskl used in treating thoracic malignancies , especially left lung cancer.

关 键 词：胸部肿瘤 放射治疗 心电图异常 心脏 

分 类 号：R734[医药卫生—肿瘤]