心电图与心电向量图在房缺诊断中的应用  

Analysis of atrial septal defect electrocardiogram and vectorcardiogram

作　　者：耿旭红[1] 尹希[1] 王永权[2] 

机构地区：[1]河北医科大学第四医院功能科,050011 [2]中国医科大学第一医院,110001

出　　处：《临床心电学杂志》2016年第3期204-207,共4页Journal of Clinical Electrocardiology

摘　　要：目的探讨原发孔型房间隔缺损(PASD)与继发孔型房间隔缺损(SASD)的心电图(ECG)与心电向量图(VCG)特点。方法分析29例ASD患者的ECG与VCG特点,其中PASD13例,SASD16例,ASD诊断均经心脏超声心动图确诊未予以手术治疗。结果 ASD患者的ECG与VCG的共同特点为右心室大、多伴有完全性或不完全性右束支阻滞(CRBBB或ICRBBB),而PASD患者的ECG多具有一度房室阻滞、电轴左偏、下壁导联呈rSr′型的特点;SASD患者的ECG多具有电轴右偏、下壁导联呈钩型R波的特点。结论 ECG与VCG的电轴偏移与下壁导联的QRS波特点是鉴别PASD与SASD在电学方面的重要指标。Objective To investigate the characteristics of electrocardiogram and vectorcardiogramprimary for atrial septal defect with secundum atrial septal defect. Methods Twenty-nine cases of patients with ASD, including 13 cases of primum atrial septal defect（PASD） and 16 cases of secundum atrial septal defect（SASD）, were collected for analysis of ECG and VCG. All ASD cases were diagnosed by echocardiography were not treated surgically.Results In case s of ASD, ECG and VCG shows common characteristics of right ventricle, accompanied by fully or incomplete right bundle branch block（CRBBB or ICRBBB）. The ECG of PASD patients has increased ratio of once atrioventricular block, left axis partial and RSR＇ characteristics of inferior wall lead. While the EEG of SASD patientsare often with right axis deviation, inferior in the hook type R wave. Conclusion Identification of QRS wave axis offset of ECG and VCG, combined with the inferior should be applied as potential index toelectrically diagnose patients with PASD and/or SASD.

关 键 词：房间隔缺损 钩型R波 心电图 心电向量图 

分 类 号：R541.1[医药卫生—心血管疾病] R540.41[医药卫生—内科学]