骨折并发急性肺栓塞的心电图观察

Electrocardiographic Changes in Acute Pulmonary Embolism Following Fractures

目的探讨骨折并发急性肺栓塞的心电图变化和临床意义。方法分析23例骨折并发急性肺栓塞患者治疗前后心电图特点。结果骨折并发急性肺栓塞经治疗后窦性心动过速、SⅠQⅢTⅢRavR电压增高、顺钟向转位、心电轴右偏（〉＋90°）、低电压、期前收缩等心电图指标有明显改善，差异有显著性意义（P〈0.05）。住院期间死亡3例，其中心脏性猝死1例。结论骨折并发急性肺栓塞心电图改变虽然是非特异性的，但如能结合患者呼吸困难、胸痛、咳嗽等症状，并及时仔细观察心电图的改变，对诊断急性肺栓塞具有重要价值。

Objective To discuss electrocardiographic（ECG） changes in acute pulmonary embolism following fractures and their clinical significance. Methods ECG characteristics were analyzed before and after treatment in 23 patients with acute pulmonary embolism following fractures. Results The parameters such as sinus tachycardia, SⅠQⅢTⅢRavR, R amplitude in lead aVR, clockwise rotation, right axis deviation （ 〉＋90° ）, low voltage, and premature beats improved significantly after treatment （P〈0.05）. Three patients died during hospitalization with one sudden cardiac death. Conclusion Combining with symptoms such as dyspnoea, chest pain, and cough, non-specific ECG changes are of important values in diagnosing acute pulmonary embolism in patients with fractures.