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目的探讨心电图在筛查急性肺栓塞中的临床价值,为临床急性肺栓塞的筛查提供参考。方法对福建医科大学附属第一医院干部病房2008年4月至2010年4月收治并确诊的42例急性肺栓塞患者进行心电图检查,并对特定的指标进行定量分析总结。结果①42例急性肺栓塞患者仅有4例心电图改变为阴性,其余的改变均为阳性;按照阳性率高低依次为SI>1.3mv(42.9%)、顺钟向转位(38.1%)、胸前导联T波倒置(33.3%)、窦性心动过速(33.3%)、SIQⅢTⅢ(28.6%)、RV1+SV5>1.05mv(9.5%)不完全右束支传导阻滞(9.5%)RAVR>0.5mv(4.7%)。②不同的年龄组在SIQⅢTⅢ(P<0.05)、RAVR>0.5mv(P<0.01)、顺钟向转位(P<0.01)、RV1+SV5>1.05mv(P<0.05)、不完全右束支传导阻滞(P<0.05)的分布有差异。③不同的D-二聚体水平组在SIQⅢTⅢ(P<0.05)、SI>1.3mv(P<0.01)、RAVR>0.5mv(P<0.05)、顺钟向转位(P<0.01)、窦性心动过速(P<0.01)、胸前导联T波倒置(P<0.05)的分布有差异。结论肺栓塞心电图改变阳性率较高且无创方便可动态观察,同时配合其他检查,可进行急性肺栓塞的筛查,具有重要的临床价值。
Objective To investigate the clinical value of electrocardiogram in the screening of acute pulmonary embolism and provide a reference for clinical screening of acute pulmonary embolism. Methods Forty-two patients with acute pulmonary embolism admitted to the First Affiliated Hospital of Fujian Medical University from April 2008 to April 2010 were examined by electrocardiogram (ECG), and the specific indicators were quantitatively analyzed and summarized. Results ① Only 4 of 42 patients with acute pulmonary embolism had negative electrocardiogram (ECG) changes and all the other changes were positive. According to the positive rate, SI> 1.3mv (42.9%), clockwise transposition (38.1% Lead T wave inversion (33.3%), sinus tachycardia (33.3%), SIQIIIT III (28.6%), RV1 + SV5> 1.05mv (9.5%) incomplete right bundle branch block (RAVR> 0.5mv (4.7%). (2) In different age groups, there were significant differences in SIQⅢTⅢ (P <0.05), RAVR> 0.5mV (P <0.01), clockwise turn (P <0.01), RV1 + SV5> 1.05mv Branch conduction block (P <0.05) the distribution of differences. ③Different D-dimer levels in SIQⅢTⅢ (P <0.05), SI> 1.3mV (P <0.01), RAVR> 0.5mV (P <0.05) Tachycardia (P <0.01), there was a difference in the distribution of T wave in chest lead (P <0.05). Conclusion The positive rate of pulmonary embolism electrocardiogram change is high and noninvasive convenience can be observed dynamically. In combination with other tests, screening for acute pulmonary embolism is of great clinical value.