心电图在急性肺栓塞诊治中的应用价值

王鹏，陈君蓉*，李宝芸，耿瑜

（陕西省宝鸡市中心医院功能科，陕西 宝鸡，721008）

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摘要：

目的 探究心电图在急性肺栓塞（APE）治疗过程中的重要特征性变化，为临床提供应用价值。方法 选择我院2010 年1 月至2015 年9 月确诊并治疗的71 例APE 患者为研究对象，所有患者均进行心电图检查，符合溶栓治疗者59 例，均给予溶 栓治疗；不符合溶栓治疗者12 例，采用抗凝治疗。统计和比较患者治疗前、后的心电图变化。结果 71 例患者中有68 例（95.77%）心电图有异常变化，其中60 例SI>0.1 mV（84.51%），47 例SIQⅢTⅢ（66.20%），33 例QⅢTⅢ型（46.48%），30 例avR 主波向上（42.25%），35 例Tv1-v3 倒置（49.30%），25 例Tv1-v5 倒置（35.21%），6 例肺性P （8.45%），54 例窦性心动过速 （76.06%），11 例右束支传导阻滞（15.49%），12 例电轴右偏（16.90%），15 例房性心率失常（21.13%），40例顺钟向转位 （56.34%）。治疗7 d 后心电图显示以上指标阳性率均减少，与治疗前比较，差异均有显著性意义（P<0.05）。结论 大部分APE患者中出现了心电图异常变化，但无特征性的改变，仔细观察心电图特征对于APE 的诊断及观察治疗过程中病情变化具有 很重要的应用价值。

关键词：急性肺栓塞（APE）；心电图；诊治

中图分类号：R563.5文献标志码：A文章编号：2096-1413(2018)02-0130-02

Application value of the electrocardiogram in the diagnose of acute pulmonary embolism
WANG Peng, CHEN Jun-rong*, LI Bao-yun, GENG Yu
(Function Department, Baoji Central Hospital, Baoji 721008, China)

ABSTRACT: Objective To explore the characteristics of electrocardiogram (ECG) in patients with acute pulmonmary embolism (APE). Methods A total of 71 patients with APE diagnosed and treated in our hospital from January 2010 to September 2015 were selected as the study objects, and all patients received ECG. Fifty-nine cases of patients in line with the thrombolytic therapy were given thrombolytic therapy; the other 12 cases of patients were given anticoagulant therapy. The changes of ECG before and after treatment were counted and compared. Results Of the 71 patients, 68 (95.77%) had abnormal ECG changes. Among them, the abnormally rate of ECG by turn were SI>0.1 mV 60 cases (84.51%), SIQⅢTⅢ 47 cases(66.20%), QⅢTⅢ (46.48%), avR dominant wave upward 30 cases(42.25%), Tv1-v3 inversion 35 cases (49.30%), Tv1-v5 inversion 25 cases (35.21%), P pulmonale 6 cases (8.45%), Sinus tachycardia 54 cases (76.06%), right bundle branch block 11 cases (15.49%), right axis deviation 12 cases (16.90%) atrial arrhyttmia 15 cases (21.13%) and clockwise rotation 40 cases (56.34%). After 7 d of therapy, the rate of above indicators in ECG showed decreased significantly (P<0.05). Conclusion The majority of patients with APE have abnormal ECG changes, but no characteristic changes. careful observation of ECG characteristics for the diagnosis of APE and observation of the changes in the course of treatment has very important value.

KEYWORDS: acute pulmonmary embolism (APE); electrocardiogram (ECG); diagnose

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