先天性心脏病患者开胸术后心电图分析

ECG analysis of patients with congenital heart disease after thoracotomy

目的探讨分析先天性心脏病患者开胸术后心电图的变化情况与发生原因。方法符合纳入标准的58例先天性心脏病开胸手术患者为对象,患者来源于2016年1月至2017年12月,术前心电图显示表现为房室肥大,且无其他异常改变,患者均接受开胸手术,于术后1周和3个月复查患者心电图,观察术后心电图的变化。结果 58例先天性心脏病患者术后心电图以ST段抬高呈现急性心肌损伤和右束支阻滞的比例最高,患者术后1周分别为25例(43.10%)和39例(67.24%),术后3个月分别为5例(8.62%)和17例(29.31%)。术后1周患者窦性心动过速、交界性心动过速、室性心律失常、ST段抬高呈急性损伤性改变和右束支阻滞的发生比例显著高于术后3个月(P<0.05)。结论先天性心脏病开胸手术后心电图的改变与手术部位、手术方式和心脏再灌注等因素有关,对于患者术后的复查采用心电图辅助检查可直观了解心脏情况,为诊治提供依据。

Objective To investigate the changes and causes of electrocardiogram in patients with congenital heart disease after thoracotomy.Methods Fifty-eight patients with congenital heart disease with thoracic surgery that met the inclusion criteria were included as the subjects.The patients were from January 2016 to December 2017.The preoperative electrocardiogram showed atrioventricular hypertrophy and no other abnormal changes.All patients underwent thoracic surgery.The ECG was rechecked at 1 week and 3 months after surgery,and the changes of postoperative electrocardiogram were observed.Results The proportion of acute myocardial injury and right bundle branch block was the highest in 58 patients with congenital heart disease.at 1 week after operation were 25(43.10%)and 39(67.24%),5(8.62%)and 17(29.31%)at 3 months after operation.The incidence of sinus tachycardia,borderline tachycardia,ventricular arrhythmia,ST-segment elevation and right bundle branch block were significantly higher than 3 months after operation(P<0.05).Conclusion The changes of ECG after thoracotomy of congenital heart disease are related to the operation site,operation mode and cardiac reperfusion.to provide the basis for diagnosis and treatment.