肺栓塞的心电图改变

ECG change of acute pulmonary embolism

目的 探讨心电图变化在诊断急性肺栓塞中的意义。方法 回顾分析 10例 (男 6例、女 4例 ,平均年龄45 .4岁 )经右心导管及肺动脉造影证实并排除其它肺及心脏疾病的肺栓塞病人的心电图变化。结果 所有病例有以下不同的心电图改变 :①窦性心动过速 70 %。②SⅠ 6 0 %、QⅢ 70 %、TⅢ 90 %。特别是新出现的上述变化。③电轴右偏 30 %或不确定者 2 0 % ,后者表现为Ⅲ导联呈Qr型。④一过性右束支传导阻滞 2 0 %。⑤右侧胸前导联倒T10 0 %。⑥顺钟向转位 2 0 %。⑦右室肥厚 10 %。以上变化呈一过性、动态变化之特征。结论 心电图呈一过性动态变化 ,主要出现在急性期。心电图变化是非特异性的 。

Objective To investigate the ECG change of acute pulmonary embolism.Methods We analyzed 10 patients(male 6,female 4,aged 35 to 58,average 45.4)ECG who have been diagnosed as pulmonary embolism by pulmonary artery angiography.Results ①Sinus techycardia(2/10);②S in lead Ⅰ(6/10),Q in lead Ⅲ(7/10);③QRS axis >90° or indeterminate(2/10) which Qr in lead Ⅲ;④transient right bundle branch block(2/10);⑤T wave inversion in right chest leads(10/10);⑥clock wise rotation(2/10);⑦right ventricular hypertrophy(1/10).Conclusion The most characteristic ECG of this disorder is transient and dynamic changes.So we should constantly record the ECG in time.There is no significantly relevance between the changes of ECG and the severity of pulmonary embolism.Normal ECG can't exclude pulmonary embolism.