急性肺栓塞的心电图表现特点分析  

The Significance and Role in the Diagnosis of Acute Pulmonary Embolism ECG Analysis

作　　者：吴娟[1] 王军[1] 朱海龙[1] 张毅[1] 梁夷[1] 

机构地区：[1]成都大学附属医院德阳市第二人民医院,四川德阳618000

出　　处：《现代生物医学进展》2015年第20期3879-3881,共3页Progress in Modern Biomedicine

基　　金：国家自然科学基金项目(30570809)

摘　　要：目的:探讨急性肺栓塞的心电图表现特点,提高急性肺栓塞的诊断水平。方法:选取我院急诊收治的急性肺栓塞患者79例,进行床旁心电图多次动态检测,观察急性肺栓塞患者心电图的基本特点,分析心电图对急性肺栓塞的临床诊断意义。结果:在79例患者中,发生心电图改变者72例(91.14%),其中窦性心动过速者63例(79.74%),为最常见的心电图改变;Ⅰ导联S波较深者51例(64.56%);Tv1-v3倒置者45例(56.96%);Tv1-v2倒置者31例(39.24%);右束支传导阻滞改变者27例(34.17%);Tv1-v4倒置者18例(22.78%)。典型的肺栓塞SⅠQⅢTⅢ心电图表现少见,仅14例(17.72%),而心电图表现为QⅢTⅢ者49例(62.02%)。结论:急性肺栓塞的心电图改变具有非特异性和复杂多变性,临床医生应将心电图检查结果作为诊断依据之一,仍需结合患者的临床表现,进行综合分析判断,再给予合理诊断及时治疗,以改善急性肺栓塞患者的预后。Objective： To investigate the electrocardiogram characteristics of acute pulmonary embolism and improve the diagnostic level of acute pulmonary embolism. Methods： 79 patients with acute pulmonary embolism admitted in the emergency department of our hospital were selected and dynamically tested by the bedside ECG for many times, the basic characteristics of electrocardiogram in patients with acute pulmonary embolism were observed, and the clinical and diagnostic significance of electrocardiogram for the acute pulmonary embolism was analyzed. Results： In 79 cases of patients with acute pulmonary embolism, changes of electrocardiogram were observed in 72 eases（91.14%）, including 63 cases （79.74%） of sinus tachycardia which was the most common change of ECG, 51 cases （64.56%） with deep Lead I S waves, 45 cases （56.96%） of Tvl-v3 inversion, 31 cases （39.24%） of Tv1-v2 inversion, 27 cases （34.17%） of fight bundle branch block change, 18 cases （22.78%） of Tv1-v4 inversion, Typical pulmonary embolism S I QⅢTIⅢ ECG findings was relatively rare, including only 14 cases （17.72%）, and electrocardiogram characterized by QⅢTIⅢ was observed in 49 cases （62.02%）. Conclusions： The ECG changes of acute pulmonary embolism had nonspecificity and complicated variety, clinicians should closely combine the clinical manifestation with comprehensive analysis and judgment, attach great importance to the risk factors, avoid electrocardiogram diagnosis error, and improve the clinical diagnostic value.

关 键 词：急性肺栓塞 心电图 诊断 临床意义 

分 类 号：R563.5[医药卫生—呼吸系统]