摘要
目的了解心电虱对肺栓塞诊断的临床价值。方法分析我院2013年9月。2015年9月经CTA确诊的55例肺栓塞心电图。结果肺栓塞心电图不典型，没有一个指标的发生率超过50％。SfQⅢTⅢ占30．9％；肺性P波占14．5％；电轴右偏占23．6％；顺钟向转位占34．5％；右束支传导阻滞占29．1％；avR导R增高占41．8％：右室高电．压占23．6％；胸导T倒置从右到左“先渐深后渐浅”占49．I％；QRS电交替占36．4％；Sv1-v5钝挫占10．9％。结论合理看待心电图对肺栓塞诊断的临床价值：肺栓塞心电图的本质是右心压力负荷急剧升高导致的心电生理改变。心电图对肺栓塞的意义在于发现右室压力负荷急剧增加的证据，是启动相关确证检查的“扳机”。心电图对肺栓塞的意义：敏感性重于特异性。Dianiel心电图评分包含多项右室负荷急性增高指标，可提高肺栓塞诊断的特异性及敏腻件．
Objective To explore the clinical value of ECG in initial diagnosis of pulmonary embolism. Methods The ECG of 55 cases of pulmonary embolism that were confirmed by CTA from September 2013 to September 2015 were analyzed. Results The EICG of pulmonary embolism was not typical, with no incidence rate of any indicator over 50%. The proportion of SI QmTm was 30.9%; pulmonary p wave was 14.5%; right axis deviation was 23.6%; clockwise rotation was 34.5%, fight bundle branch block was 29.1%; avR-lead R increase was 41.8%; high voltage of fight ventricle was 23.6%; thorax-lead T inversion with right-to-left ＂first deepening and then lightening＂ was 49.1%; QRS electrical al- ternation was 36.4%; an,：l blunt Sv1-v5 was 10.9%. Conclusion The clinical value of ECG in diagnosis of pulmonary em- bolism should be treated properly. The mechanism of ECG in pulmonary embolism is the sharp increase of right heart pressure load causing electrophysiological changes. The significance of ECG in pulmonary embolism is to discover the evidence of sharp incresase of right heart load, which can be called the trigger to initiate related confirmative inspec- tions. The significance of ECG in pulmonary embolism is more about sensibility than specificity. Dianiel ECG scoring contains several indicators about sharp increase of right heart load, thus can improve the specificity and sensibility of the diagnosis of pulmonary embolism.
出处
《中国现代医生》
2016年第18期95-98,共4页
China Modern Doctor
关键词
肺栓塞
右心负荷
心电图
临床价值
Pulmonary embolism
Right heart load
ECG
Clinical value
