急性肺血栓栓塞症溶栓治疗后心电图变化

Electrocardiogram Changes After Thrombolytic Therapy for Acute Pulmonary Thromboembolism

目的 分析急性肺血栓栓塞症患者溶栓治疗前后的心电图变化特征.方法 选取笔者所在医院呼吸内科2017年2月—2019年2月收治的急性肺栓塞栓塞症患者40例作为研究对象,对其进行溶栓治疗,比较治疗前后心电图变化情况.结果 溶栓治疗后,心电图正常患者仅7例,异常项目超过3项者达24例;窦性心律过速、S1QmTm、QmTm、Tv1-v3等各项指标均有显著降低(P<0.05);电轴右偏、肺性P波、房颤或房扑、右束支传导阻滞、S1的变化不明显(P>0.05).结论 急性肺血栓栓塞症患者的心电图具有非特异性,表现多样化,对患者心电图动态变化情况进行实时监测观察,并结合临床症状,可为临床提供最早的诊断资料,尽快作出有效的治疗方案.

Objective To analyze the electrocardiographic characteristics of patients with acute pulmonary thromboembolism before and after thrombolytic therapy.Methods 40 patients with acute pulmonary embolism admitted to respiratory medicine department of our hospital from February 2018 to February 2019 were selected as the research objects,and treated with thrombolytic therapy.The changes of ECG before and after treatment were compared.Results After thrombolytic therapy,there were only 7 patients with normal ECG and 24 patients with more than 3 abnormal items.Sinus tachycardia,S1QmTm,QmTm,Tv1-v3 and other indicators were significantly decreased(P<0.05);right axis deviation,pulmonary P wave,atrial fibrillation or flutter,right bundle branch block and S1 did not change significantly(P>0.05).Conclusion The ECG of patients with acute pulmonary thromboembolism is non-specific and diversified.Real-time monitoring and observation of the dynamic changes of ECG and clinical symptoms can provide the earliest diagnostic data and make effective treatment as soon as possible.