远程动态心电实时监测的临床意义

Clinical significance of real-time remote dynamic electrocardiogram monitoring

目的探讨远程动态心电实时监测的临床意义。方法选取2018年3月至2019年3月本院接收的急性心肌梗死患者76例作为研究对象,所有患者均佩戴同步心电图记录器,实施远程心脏监护。记录不同时期心律失常检出情况、心律失常与梗死部位的关系、心律失常与ST段改变的关系。结果发病后24 h内,室性心律失常及室上性心律失常发生率均较高,其中室上性早搏发生率为60.53%,室上性心动过速发生率为7.89%,复杂室性心律失常发生率为44.74%,室性单纯性发生率为35.53%;单个梗死组早搏发生率为81.82%,高于广泛梗死组,差异有统计学意义(P<0.05);心内膜下梗死组心动过速发生率为46.15%,高于单个梗死组及广泛梗死组,差异有统计学意义(P<0.05);广泛梗死组复杂室性心律失常发生率为56.67%,高于心内膜下组及单个组,差异有统计学意义(P<0.05);ST段改变及无改变的患者复杂室性心律失常发生率比较差异无统计学意义。结论在急性心肌梗死患者中应用远程动态心电实时监测具有重要意义,利于发现恶性事件,利于患者早期接受治疗。

Objective To investigate the clinical significance of real-time remote dynamic electrocardiogram monitoring.Methods 76 patients with acute myocardial infarction in the hospital from March 2018 to March 2019 were selected as objects.All patients wore synchronized electrocardiogram recorder for remote cardiac monitoring.The detection of arrhythmia at different time,relationship between arrhythmia and infarction area,relationship between arrhythmia and ST segment changes were recorded.Results After onset within 24 h,the incidence of ventricular arrhythmia and supraventricular arrhythmia was higher,the incidence of supraventricular premature beat,supraventricular tachycardia,complex ventricular arrhythmia and simple ventricular arrhythmia were 60.53%,7.89%,44.74%,35.53%,respectively.The premature beat rate in the single infarction group was 81.82%,higher than that in the extensive infarction group,and the difference was statistically significant(P<0.05).The rate of tachycardia in the subendocardial infarction group was 46.15%,which was higher than that in the single infarction group and the extensive infarction group,the difference was statistically significant(P<0.05).The incidence of complex ventricular arrhythmia in extensive infarction group was 56.67%,which was higher than that in subendocardial group and single group(P<0.05).There was no statistical difference in the incidence of complex ventricular arrhythmia between ST-segment change and no-ST-segment change.Conclusion Real-time remote dynamic electrocardiogram monitoring in patients with acute myocardial infarction has important significance,which can detect the malignant events and facilitate the early treatment of patients.