气胸致肺不张患者的心电图分析

Analyzing the relationship between the pneumothorax electrocardiogram changes and pulmonary compression in pneumothorax patients

目的分析气胸患者不同程度肺不张时的心电图改变。方法入选122例经X线胸片证实为气胸患者的心电图进行回顾性分析,根据肺压缩程度分为三组。轻度气胸组:肺压缩1%～20%,共33例;中度气胸组:肺压缩21%～50%,共30例;重度气胸组:肺压缩51%～100%,共59例,分析各组心电图改变及意义。结果①窦性心动过速的发生率分别为:轻度气胸组24.24%(8/33)、中度气胸组50.00%(15/30)、重度气胸组61.02%(36/59),三组间存在差异(x2=11.50,p<0.01);②左胸导联R波递增不良发生率分别为:轻度气胸组33.33%(11/33)、中度气胸组83.33%(25/30)、重度气胸组42.37%(25/59),三组间存在差异(x2=18.37,p<0.01);③左侧胸导联低电压发生率分别为:轻度气胸组9.09%(3/33)、中度气胸组30.00%(9/30)、重度气胸组10.17%(6/59),三组间存在差异(x2=15.12,p<0.01);④其余类型的心电图改变在各组间无明显差异。结论气胸患者中,不同程度肺压缩时,心电图改变,如窦性心动过速、左侧胸导联R波递增不良和左侧胸导联低电压的发生率不同,对判断病情的严重程度有一定意义。

Objective To investigate the relationship between the pneumothorax electrocardiogram changge and the extent of pulmonary compression. Methods We retrospectively analyse electrocardiograms of 122 pneumothorax patients who was diagnosed by chest radiograph, which were divided into three groups according to the degree of pulmonary compression.1%-20% pulmonary compression was mild group （33 patients）, 21%-50% was moderate group（30 patients）, 51%-100% was severe group（59 patients）, then we analyzed the relationship of the degree of pulmonary compression between each group and their electrocardiograms. Results The percentage of sinus tachycardia in mild group was 24.24%（8/33）, in moderate group was 50.00%（15/30）, and in severe group was 61. 02%（36/59）, there was variation among the three groups （x^2=-11.50,p〈0.01）. The percentage of insufficient the left of chest lead R wave increase in mild group was 33.33% （11/33）, in moderate group was 83.33%（25/30）, and in severe group was 42.37%（25/59）, there was variation among the three groups（x^2=18.37,p〈0.01 ）. The percentage of the left of chest lead low voltage in mild group was 9.09%（3/33）, in moderate group was 30.00%（9/30）, and in severe group was 10.17%（6/59）, there was variation among the three group （x^2=15.12,p〈0.01）.Other types of electrocardiograms have no abvious variation amongst these groups. Conclusions The electrocardiogram changes had the most notable relationship with the degree of pulmonary compression in the pneumothorax patients includeing the sinus tachycardia, insufficient R wave increase and low voltage in the left of chest lead.