摘要
目的:探讨肺栓塞部位及溶栓治疗前后与心电图改变的关系。方法:回顾性分析60例确诊肺栓塞患者不同梗塞部位、溶栓治疗前后及出院前心电图变化。结果:1.不同肺栓塞部位心电图改变:右肺栓塞心电图表现,主要为SⅠ,SⅠQⅢTⅢ,QⅢTⅢ,TⅢ倒置,TV1-V2倒置,SV1-V5R挫折,粗顿,ICRBBB或CRBBB。而左肺栓塞心电图主要表现在SⅠ,TⅢ倒置,TV1-V2倒置及TV1-V5倒置,上肺叶栓塞的ECG改变<下肺叶,单节段损害ECG改变<多节段损害;2(1)入院时,SⅠ>0.1mv,51例次(85%)SⅠ>QⅢTⅢ37例次(61.67%),QⅢTⅢ37例次(61.67%),TⅢ倒置50例次(83.3%),TV1-V2倒置40例次(66.67%),TV1-V3倒置32例次(53.33%),Tv1-v4倒置27例次(45%),TV1V5倒置7例次(11.67%),SV1-V5R挫折、粗钝31例次(51.67%),ICRBBB或CRBBB8例次(13.33%)。(2)溶栓后ECG变化,SⅠ变浅,QⅢ波减小或消失,TⅢ倒置变浅,TV1-V2倒置加深,ICRBBB、CRBBB减轻或消失,RavR可迅速下降至正常。(3)出院前变化,RⅡ增加,QⅢ减小,TⅢ变直立,Tv2直立。结论:肺栓塞部位与心电图改变亦密切相关。因此,可根据心电图的变化来评估肺栓塞的部位及面积。早期积极溶栓治疗能显著改善病人预后,动态观察溶栓前后典型或不典型心电图的变化有助于病情评估。
Objective： To observe the relationship between the different region of pulmonary embolism （PE）, preorpost thrombolysis and the changes of ECG. Methods： Retrospective analysis of ECG changes in different region of PE and pre or post thrombolysis. Result： 1. The changes of ECG in different region of PE were ： （ 1 ） right pulmonary embotism showed： SⅠ,SⅠQⅢTⅢ , the negative of T waves in Ⅲ, Tv1-v2, SV1-V5R slured, ICRBBB or CRBBB. （2） left pulmonary embolism were showed ： SⅠ , the negative of T waves in Ⅲ , TV1 - V2, TV1 - V5. （ 3 ） superior pulmonary lobes were much less than that in inferior pulmonary lobes. The ECG changes in single pulmonary segment were less than that in poly pulmonary segrents. 2. （ 1 ） The ECG changes in admission were： SⅠ 〉 0. lmv in 51times （85% ）, SⅠ QⅢ TⅢ pattern in 37times （ 61.7% ）, QⅢ TⅢ pattern in 37times （61.67%）, TⅢ inbrtdion in 50times （83.30%）. The segative T waves in V1-2 in 40times （66.67%）, in V1-3 in 32times （ 53.33 % ）, in V1 - 4 in 27times （ 45 % ）, in V1-5 in 7times （ 11.67 % ）, Sv1-v5R slurred in 31 times （ 51.67 % ）, ICRBBBorCRBBB in 8times （ 13.33% ）. （2） posthrombolytie. ECG changes were： SI reduced, QⅢ decreased or disappeared, TⅢ wave inversion shallowed, Tv1- v2 inversion deeped. ICRBBB or CRBBB disapperared RavR decreased to normal. （3） Befor predischarge the ECG changes as follows： RⅢ increased. QⅢ reduced, TⅢ Tv2 waves became upright. Conclusions： Different ECG changes in different region of PE were showed. We can estimate the region and area of PE. Thrombolysis actively may further improve the prognosis. It may be used for assessment of the patient＇s eondition.
出处
《华西医学》
CAS
2005年第4期648-649,共2页
West China Medical Journal
关键词
肺栓塞
心电描记术
溶栓
Pulmonary embolism
leetreardiography
thrombolysis
