急性硬脑膜下血肿微创术前后心电图变化探讨  

Electrocardiogram changes in patients with acute subdural hematoma

作　　者：朱建华[1] 张永林[1] 孙敏丽[1] 

机构地区：[1]江苏省滨海县人民医院,224500

出　　处：《临床心电学杂志》2010年第2期116-117,共2页Journal of Clinical Electrocardiology

摘　　要：目的探讨急性硬脑膜下血肿致心电图的变化及机制。方法入选126例急性硬脑膜下血肿微创血肿清除术患者,观察患者术前术后的心电图变化。结果126例急性硬脑膜下血肿患者的心电图均出现异常,微创血肿清除术后65例恢复正常,5例因脑干出血破入脑室致心衰室颤而死亡,9例好转,48例因原有心脏病史和继发于脑损害的心脏改变。结论急性硬脑膜下血肿致颅内压增高,引起脑缺血、缺氧,而使下丘脑植物神经中枢的活动张力改变,出现交感神经和副交感神经的不平衡状态,引起心脏传导系统和心肌复极异常以及心肌损害,而引起心电图异常。急性硬脑膜下血肿心电图异常系脑心综合征所致。Objective To investigate ECG changes in patients with acute subdural hematoma. Methods To observe ECG changes in 126 patients with acute subdural hematoma before and after mini-invasive hematoma aspiration. Results Abnormal changes existed in ECG of all 126 patients, 48 patients with preexist heart diseases and the secondary cases structural abnormality, 65 patients recovered and 9 improved after mini-invasive hematoma aspiration, 5 patients died due to Brain stem hemorrhage, heart failure and ventricular fibrillation. Conclusions Acute subdural hematoma increased the intracranial pressure witch leading to cerebral ischemia and anoxia. These changed the active tension of autonomic nerve and resulted in the imbalance between sympathetic and parasympathetic nerve. These caused the repolarization abnormality and the myocardial damage, and resulted in the ECG abnormality. The abnormal ECG presentation of patients with acute subdural hematoma is related to the cerebral-cardio syndrome.

关 键 词：硬脑膜下血肿 脑心综合征 心电图 

分 类 号：R651.1[医药卫生—外科学]