危重患者急救中心电图RT融合的危险性  

Risk of ECG RT fusion in the first-aid of critically ill patients

作　　者：郑文凯[1] 林秋辉 刘林勇[3] Zheng Wen-kai;Lin Qiu-hui;Liu Lin-yong(Department of ECG,Zhangzhou Hospital,Zhangzhou Fujian 363099;Zhangzhou Emergency Center,Zhangzhou Fujian 363099;Statistical Department of Zhangzhou Hospital,Zhangzhou Fujian 363099,China)

机构地区：[1]漳州市医院心电图室,福建漳州363099 [2]漳州市急救中心,福建漳州363099 [3]漳州市医院统计室,福建漳州363099

出　　处：《实用心电学杂志》2019年第6期438-442,450,共6页Journal of Practical Electrocardiology

摘　　要：目的分析危重患者急救过程中的心电图RT融合现象对预后的影响。方法选取218例危重患者描记心电图,按ST段是否消失,分为RT融合组和RT不融合组;另根据患者心率差异细分为心动过速组、正常心率组、心动过缓组。比较各组QRS波宽度、QT间期、QTc间期以及死亡率的差异。结果在心动过缓与心率正常的患者,RT融合组与RT不融合组的QRS波宽度、QT间期、QTc间期、死亡率间的差异均有统计学意义(P均<0.05)。而心动过速患者中,融合组与不融合组QRS波宽度、QT间期、QTc间期均无明显差异(P均>0.05),但死亡率差异有统计学意义(P<0.05)。结论危重患者急救中心电图出现RT融合现象实质是心肌严重缺血,心室率由快到慢反映心肌缺血程度的进展趋势。Objective To analyze the effect of electrocardiogram(ECG)RT fusion on prognosis in first aid.Methods ECGs were recorded in 218 critically ill patients.According to whether or not the ST segment disappears,they were divided into RT fusion group and non-fusion group first.Then they were further divided into tachycardia group,normal heart rate group and bradycardia group according to different heart rates.The QRS wave width,QT interval,QTC interval and mortality were compared among the different groups.Results There was significant difference in QRS wave width,QT interval,QTc interval and mortality between RT fusion group and non-fusion group in the patients with bradycardia and normal heart rate(P<0.05).There was no significant difference in QRS wave width,QT interval and QTc interval(P>0.05)between RT fusion group and non-fusion group in the patients with tachycardia except mortality.Conclusion The essence of RT fusion phenomenon in emergency center of critically ill patients is serious myocardial ischemia,and the ventricular rate reflects the development trend of severity of myocardial ischemia from fast to slow.

关 键 词：心肌缺血 RT融合 死亡率 

分 类 号：R540.41[医药卫生—心血管疾病]