儿科急诊心电图异常的相关因素分析(附225例报告)  

Correlative Factors Analysis of Abnormal Electrocardiograms in Pediatric Emergency Department

作　　者：余亚娟[1] 王芳[1] 包保芳 王琳[1] YU Ya-juan;WANG Fang;BAO Bao-fang(Department of cardiac function,Wuxi People's Hospital Affiliated to Nanjing Medical University,Wuxi Jiangsu 214023,China)

机构地区：[1]南京医科大学附属无锡市人民医院心内科

出　　处：《湖北科技学院学报（医学版）》2019年第6期479-481,共3页Journal of Hubei University of Science and Technology(Medical Sciences)

摘　　要：目的探讨儿科急诊可能出现心电图异常的相关因素。方法回顾性分析我院儿科急诊进行心电图检查的225例患儿临床资料,所有患儿既往无明显心脏病病史,观察分析患儿主诉、病史、异常生命体征等因素与出现异常心电图的相关性。结果 225例患儿的心电图中,42例(18.6%)出现异常改变,其中13例(5.7%)为室上性心动过速,10例(4.4%)为窦性心动过缓,8例(3.5%)为QT间期延长,5例(2.2%)为左心室肥大,2例(0.9%)为ST段抬高,2例(0.9%)为异常T波倒置,1例(0.4%)为室性早搏,1例(0.4%)为房室传导阻滞。Logistic回归分析显示,心动过速(OR=1.81,95%CI:1.23~2.98)及心动过缓(OR=3.72,95%CI:1.53~9.45)等异常生命体征变化与异常心电图改变明显相关,而包括晕厥(OR=0.324,95%CI:0.32~0.67)、胸痛(OR=0.387,95%CI:0.17~0.83)、呼吸系统疾病(OR=0.485,95%CI:0.29~0.81)和胃肠道疾病(OR=0.414,95%CI:0.12~0.79)等主诉及病史的患儿与异常心电图改变的相关性低。结论既往无心脏病病史的儿科急诊患儿有心率变化等临床主诉或体征变化与出现异常心电图相关性高,而主诉晕厥、胸痛或诊断胃肠道和呼吸系统疾病的患儿出现异常心电图可能性低,可作为独立的预测因子。Objective To explore correlative factors analysis of abnormal electrocardiograms(ECGs) in pediatric emergency department. Methods A retrospective study was performed on the medical records of 225 children without significant cardiac disease history in the previous who had ECG performed during emergency department stay from January 2017 to December 2018.We observed and analyzed the correlation between abnormal ECGs and clinical date on vital signs and medical history of all children.Results Of 225 children,42 children(18.6%) had abnormal ECGs including supraventricular tachycardia(5.7%),bradycardia(4.4%),prolonged QTc interval(3.5%),left ventricular hypertrophy(2.2%),ST-segment elevation(0.9%),abnormal T-wave inversions(0.9%).In a logistic regression analysis,there were significant associations between the ECGs abnormaiities and tachycardia and bradycardia.Certain chief complaints and history components were less likely to have abnormal ECGs including complaints of syncope(OR=0.324,95%CI 0.32~0.67),chest pain(OR=0.387,95%CI 0.17~0.83) and known history of respiratory disease(OR=0.485,95%CI 0.29~0.81) or gastrointestinal disease(OR=0.414,95%CI 0.12~0.79).Conclusion In this study,the children with a chief complaint of syncope,chest pain and known respiratory or gastrointestinal conditions in the emergency department have low likelihood of abnormal ECG.

关 键 词：儿科急诊 心电图 回归分析 相关因素 

分 类 号：R540.41[医药卫生—心血管疾病]