院内遥测心电监护对不明原因晕厥的诊断价值  

Diagnostic value of in-hospital telemetry electrocardiogram monitoring for unexplained syncope

作　　者：许晨曌 郭晓彬[2] XU Chenzhao;GUO Xiaobin(Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China;不详)

机构地区：[1]北京中医药大学东方医院,北京市100078 [2]首都医科大学附属北京天坛医院

出　　处：《河北医药》2022年第21期3243-3246,共4页Hebei Medical Journal

摘　　要：目的探讨院内遥测心电监护对晕厥诊断价值,为临床提供理论参考。方法57例不明原因晕厥患者住院进行监测,入院后均行常规心电图检查、动态心电图及院内遥测心电监护,分析患者心电变化与晕厥发生关系。在充分分析心电监护的基础上进行直立倾斜试验、电生理检查等,明确晕厥病因,采取相应的治疗策略。结果57例患者中,13例在遥测心电监护检测中出现≥1种的缓慢型或快速型严重心律失常(不包括早搏),其中5例患者在遥控心电监护检测期间出现晕厥发作,晕厥发作时间与检出心律失常时间一致。对其余44例患者行直立倾斜试验,26例达到阳性标准,诊断为血管迷走性晕厥。其余18例直立倾斜试验阴性患者均接受电生理检查,5例通过电生理检查发现晕厥可能病因,其余13例患者出院时晕厥原因不明。结论院内遥测心电监护对晕厥诊断有重要临床价值,明显优于普通心电图及动态心电图,能更有效发现与晕厥有关的心律失常,通过院内遥控心电监护与其他检查手段结合,可提高晕厥的诊断率。Objective To explore the diagnostic value of in-hospital telemetry electrocardiogram(ECG)monitoring for unexplained syncope(US)and to provide theoretical reference for clinic.Methods Patients with US(n=57)were treated with hospitalized monitoring,including routine ECG,dynamic ECG,as well as in-hospital telemetry ECG.The relationship between ECG changes and syncope was analyzed.On the basis of sufficient analysis of ECG monitoring,head-up tilt test(HUTT),and electrophysiological examination were carried out to identify the cause of syncope for corresponding treatment strategies.Results During telemetry ECG monitoring,thirteen of the 57 patients emerged≥1 bradyarrhythmia and tachyarrhythmia(excluding premature beats),of which,5 patients with attacks of syncope had a consistent result regardless of onset time of syncope and detection time of arrhythmias.The remaining 44 patients were managed HUTT,eligible positive criteria 26 patients were diagnosed with vasovagal syncope,eligible negative 18 patients were treated with electrophysiologic examination,5 patients with probable cause,and 13 patients with unknown cause untill discharge.Conclusion In-hospital telemetry ECG monitoring has important clinical diagnostic value for US,which is superior to general ECG and dynamic ECG.It can more effectively detect syncope-associated arrhythmia,improving the syncope diagnosis rate by combining other examination methods.

关 键 词：院内遥测心电监护 诊断 晕厥 

分 类 号：R441.2[医药卫生—诊断学]