围手术期患者突发急性心肌梗死心电图特征与临床预后关系

Analysis of Short-term Prognosis of ECG Characteristics in the Acute Myocardial Infarction of the Perioperation Period

目的 探讨非心脏手术围手术期突发急性心肌梗死 (AMI)心电图某些指标与临床近期预后险恶特点。方法 自 1981年 1月至 2 0 0 0年 12月 ,我院收治围手术期AMI 4 9例 (Ⅰ组 ) ,另随机选择同期收治非手术住院AMI 6 0例 (Ⅱ组 )进行多项指标对照分析。结果 心电图指标PTFv1负值增大 ,ΣST段抬高及Q波导联数增多 ,QTc延长以围手术期见多 (P <0 0 5～P <0 0 1)。诱发AMI以情绪焦虑、疼痛、吸烟等。并以前壁或复合前壁AMI发生率高。发病时间 7∶0 0～ 12∶0 0及并发泵衰竭、恶性心律失常、心肌梗死扩展及病死率以围手术期AMI发生明显增多 (P <0 0 5 )。结论 围手术期AMI心电图指标明显异常 。

Objective To study ECG characteristics of 49 cases of the AMI in the perioperation period and its prognstic significance.Methods 49 cases of AMI in perioperation peried (group Ⅰ) and 60 cases of AMI patients (group Ⅱ),who was conservative treatment were studied by analyses of various parameters.Results ECG characteristics of the perioperation period in PTF negative value increment and ΣST segment elevation amplitudes and Q wave derivation and QTc prolong were clearly seen,respectively(P<0 05～P<0 01).Emotional anxious and pain and smoking and the occurrence in the anterior wall of AMI ,and 7∶00～12∶00/Am etc factors - induced AMI attack.Complication,such as pump failue,infarction extension,angina pectoris,malignant arrhythmia,AMI expand,death rate were significantly higher in the perioperation peried group(P<0 05～P<0 01).Conclusion ECG characteristics of perioperation notable abnormality in the perioperation period of patients is an independent parameter,indicating poor short-term prognosis.