摘要
目的 探讨肺栓塞病人的临床及心电图特征。方法 回顾性分析近 5年来 38例肺栓塞病人的临床及心电图资料。结果 肺栓塞的危险因素包括长时间卧床 (89.5 %)、外科手术史 (5 7.9%)、心导管手术史 (7.9%)、恶性肿瘤 (10 .5 %)、下肢静脉曲张 (10 .5 %)、肥胖 (2 1.1%)和高龄 (71.1%) ;症状表现为呼吸困难 (89.5 %)、胸痛 (42 .1%)、咳嗽 (39.5 %)、发热 (7.9%)、咯血 (10 .5 %)、晕厥 (13.2 %)、癫痫发作 (2 .6 %)、猝死 (7.9) ;体征有心动过速 (6 0 .5 %)、呼吸急促 (71.5 %)、低血压 (2 6 .3%)、紫绀 (34 .2 %)、颈静脉怒张 (7.9%)、P2 亢进 (5 7.9%)、肺部罗音 (34 .2 %)、胸膜摩擦音 (7.9%)、下肢肿胀压痛 (39.5 %)。心电图的主要改变为窦性心动过速 (6 1.8%)、SIQⅢTⅢ 现象 (35 .3%)、右束支阻滞 (2 9.4%)、肺型P波 (2 3.5 %)、右室高电压 (11.8%)、ST -T改变 (47.1%)。住院期间的死亡率为 2 3.7%,其中猝死率 15 .8%。结论 肺栓塞的临床和心电图表现本身对诊断缺乏特异性 ,如能结合临床发病的特点、危险因素和心电图的动态变化则具有诊断价值。
Objective To explore the clinical and electrocardiographic characteristics pulmonary embolism.Methods Clinical and ECG data of 38 patients with pulmonary embolism in 5 years were analyzed retrospectively.Results The risk factors of pulmonary embolism included long lying in bed(89.5%), surgical operations(57.9%), cardiac intervention (7.9%), magligant tumors(10.5%), varicose vein of lower limb (10.5%), obesity(21.1%) and ageing(71.1%). The main symptoms included dyspnea(89.5%), chest pain(42.1%), cough(39.5%), fever(7.9%), hemoptysis (10.5%), syncope(13.2%), epilepsy espisodl(2.6%) and sudden death(7.9%). The signs included tachycardia(60.5%), tachypnea(71.5%), hypotension(26.3%), cyanosis (34.2%), jugular venous engorgement(7.9%), P 2 increasing(57.9%), pulmonary rales(34.2%), pleural rub(7.9%) and lower limb swelling(39.5%). The main changes in ECG were sinus tachycardia(61.8%), S IQ ⅢT Ⅲ phenomena(35.3%), RBBB(29.4%), pulmonary P wave(23.5%), right ventricular hypertrophy(11.8%) and ST-T changes (47.1%). The in-hospital mortality was 23.7%, and sudden death rate was 15.8%. Conclusion Clinical and electrocardiographic findings are not exclusive for diagnosing pulmonary embolism, but their combination with onset characteristics of symptoms, risk factors and ambulatory changes of ECG is of diagnostic and prognostic importance.
出处
《临床心电学杂志》
2003年第2期80-84,共5页
Journal of Clinical Electrocardiology
关键词
肺栓塞
临床特征
心电图
危险因素
诊断
治疗
Pulmonary embolism Electrocardiography Clinical characteristics Risk factors
