重型颅脑损伤后控制性减压的手术方式对心电图的影响

Effect of Controlled Decompression Surgery on Electrocardiogram after Severe Traumatic Brain Injury

目的探讨重型颅脑损伤后控制性减压的手术方式对心电图的影响。方法对2012年3月至2014年3月54例重型颅脑损伤的患者采用控制性减压的术式行手术治疗,所有患者术前及术后经标准12导联心电图检查,应用SPSS 13.0统计学软件分析相关结果。结果 54例重型颅脑损伤患者术前与术后两组正常心电图比较差异有统计学意义(P<0.05)。两组之间异常心电图差异主要反映在QT间期延长、窦性心动过缓及过速(P<0.05),而在异常Q波、ST-T改变、室上性心律失常及传导阻滞方面的差异无统计学意义(P>0.05)。结论控制性减压术式可明显降低重型颅脑损伤后异常心电图的发生,有效保护心肌,术后及时的监测心电图对患者治疗效果的预判以及为医师提供诊疗参考具有一定的临床意义。

Objective To explore the effect of controlled decompression surgery on electrocardiogram （ECG） after severe traumatic brain injury（sTBI）. Methods A retrospective study was carried out in 54 patients with sTBI,who received controlled decompression surgery from March 2012 to March 2014. All the pa- tients accepted 12-lead ECG examination at pre-and post-surgery,and the results were analyzed with the statisti- cal software package SPSS13.0. Results The rate of normal ECG at pre-surgery in 54 patients with sTBI was lower than the percentage of post-surgery（P 〈0.05）. There had significant differences between the two groups in the frequency of QT prolongation, supraventricular arrhythmia and sinus taehycardia or bradycardia （P 〈 0. 05）, and no statistical difference in abnormal Q wave, ST-T change and supraventricular arrhythmia and con- duction block （ P 〉 0.05 ）. Conclusion Controlled decompression surgery can significantly reduce the incidence of abnormal ECG and effectively protect myocardium after sTBI. ECG examination executed timely at post-sur- gery has the certain clinical significance in pre-judgement of curative effect and reference for medical treatment.