重型颅脑损伤后颅内压变化对心电图的影响  

The effects of intracranial pressure changes on electrocardiogram after severe traumatic brain injury

作　　者：余亚娟[1] 陈克非 

机构地区：[1]南京医科大学附属无锡人民医院心功能科,214023 [2]江苏无锡第101医院全军颅脑损伤救治中心,214044

出　　处：《临床心电学杂志》2014年第5期345-347,共3页Journal of Clinical Electrocardiology

摘　　要：目的 探讨重型颅脑损伤后不同颅内压水平对心电图的影响.方法 2010年3月至2014年3月122例重型颅脑损伤患者根据不同颅内压水平分为3组：颅内压维持20～30mmHg、颅内压维持在30～40mmHg、颅内压＞40mmHg,所有患者伤后24小时内经标准12导联心电图检查,应用SPSS 13.0统计学软件分析相关结果.结果 122例重型颅脑损伤患者心电图异常81例,占66.4％,3组之间异常心电图差异主要反映在异常Q波、QT间期延长、ST-T变化、窦性心动过缓及过速（p＜0.05）,并与颅内压水平成正相关,而在心律失常及传导阻滞方面的差异无统计学意义（p＞0.05）.结论 颅脑损伤后出现的异常心电图可作为初步评估损伤程度的参考指标,对患者病情的判断以及为医师提供诊疗参考具有一定的临床意义.Objective To explore the effects of different intracranial pressure （ICP） levels on electrocardiogram （ECG） after severe traumatic brain injury （sTBI）.Methods We made an observational retrospective study involving a group of 122 patients diagnosed as sTBI from March 2010 to March 2014.According to the different level of ICP,patients were divided into three group：ICP of the first group is maintained at 20～30mmHg.ICP of the second group is maintained at 30～40mmHg.ICP of the last group is larger than 40mmHg.All the patients accepted 12-lead ECG examination within 24 hours after injury,The results were analyzed with the statistical software package SPSS13.0.Results Of 122s TBI patients,81 patients （66.4％） had abnormal ECGs.There were significant differences between three groups in the frequency of abnormal Q wave,QT prolongation,ST-T change,supraventricular arrhythmia and sinus tachycardia or bradycardia （p＜0.05）,and not statistical signification in arrhythmia and conduction block （p＞0.05）.There were significantly positive associations between the ECG abnormalities and level of ICP.Conclusions ECG abnormalities after traumatic brain injury can be used as reference for preliminary evaluation of brain injury degree and have the certain clinical significance in judgment condition and reference for medical treatment.

关 键 词：心电图 颅内压 重型颅脑损伤 

分 类 号：R651.15[医药卫生—外科学] R540.41[医药卫生—临床医学]