急性肺栓塞心电图特征及在诊断中的作用

Electrocardiogram Characteristics and Value in diagnosis of Acute Pulmonary Embolism

目的:分析和探讨急性肺栓塞者心电图特征及在诊断中的作用。方法:选择本院在2010年1月1-2015年12月31日间收治的108例急性肺栓塞患者为研究主体。分析所有患者的心电图特征,并总结治疗前、后心电图变化情况。结果:108例患者中,有101例出现心电图改变,占比93.52%。最为常见的是窦速,共75例,占比69.44%;ST-T改变52例,占比48.15%;RBBB(右束支传导阻滞)25例,占比23.15%;S_ⅠQ_ⅢT_Ⅲ征28例,占比25.93%;PAS(房性早搏)17例,占比15.74%;肺型P波20例,占比18.52%;顺钟向转位20例,占比18.52%;电轴右偏10例,占比9.26%;室性早搏、肢体导联低电压和心电图正常均为6例,占比5.56%。结论:急性肺栓塞患者的心电图缺乏特异性表现,多为非诊断性。但是,个别特征有助于该病的诊断与鉴别,具有一定的临床价值。

Objective： To analyze and discuss the characteristics of electrocardiogram in patients with acute pulmonary embolism and its role in the diagnosis of acute pulmonary embolism. Methods： 108 cases of acute pulmonary embolism treated in our hospital from January 2010- to December 2015 were selected as the study subjects. The electrocardiogram characteristics of all patients were analyzed. The changes of ECG before and after treatment were summarized. Results： 101 cases of ECG changes in 108 cases of patients were accounting for 93.52%. The most common was sinus tachycardia including 75 cases accounting for 69.44%. ST-T changes were in 52 cases accounting for 48.15%.RBBB（RBBB） was in 25 cases accounting for 23.15%. S_IQ_III T_IIIsyndrome was in 28 cases accounting for 25.93%. PAS（APB） were in 17 cases accounting for 15.74%. Pulmonary P wave were in 20 cases accounting for 18.52%. Clockwise rotation was in 20 cases accounting for 18.52%. Right axis deviation was in 10 cases accounting for 9.26%. Ventricular premature beat, limb lead low voltage and normal ECG were 6 cases accounting for 5.56%. Conclusion： ECG in patients with acute pulmonary embolism is lack of specific performance, mostly non diagnostic. However, individual characteristics can help to diagnose and identify the disease, which has a certain clinical value.