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临床心电图检查结果及其意义有时不易判定,增加一些操作步骤或应用附加导联,可能帮助发现异常,明确诊断。一、一些较易增加的操作步骤 (一) 如P波或F波不明显可开大增益。 (二) 体位性心律失常,如体位性窦房、房室及束支传导阻滞、室早、室速和房颤等,应重点描记患者自觉症状、体征最明显的体位,并同时描记不同体位作比较。 (三) 如遇心房扑动1∶1或2∶1,以及窦性心动过速伴Ⅰ度房宣传导阻滞P(或F)波重迭于T波中,或低钾造成U、P波重迭不易辨认时,可压迫眼球或口服心得安,使心率减慢,重迭分开,往往有助于辨认。 (四) 室上性心动过速时,刺激迷走神经如出现房室传导阻滞,则为房速或窦房结折返性心动过速,可排除旁路折返及大部分房室结折返。
Clinical ECG findings and their implications Sometimes difficult to determine, add some steps or the application of additional lead, may help find abnormalities, a clear diagnosis. First, some easier to increase the operation steps (A) such as P wave or F wave is not obvious can open large gain. (B) orthostatic arrhythmia, such as the position of the sino-atrial sinus, atrioventricular and bundle branch block, ventricular tachycardia, atrial fibrillation and other early ventricular tachycardia should be described in patients with symptoms, signs of the most obvious body position, and at the same time tracing different Body position for comparison. (C) in case of atrial flutter 1: 1 or 2: 1, and sinus tachycardia with Ⅰ degree room propaganda block P (or F) wave overlap in the T wave, or potassium caused by U, P Wave overlap is not easy to identify, the ophthalmic pressure can be ophthalmic or oral safety, slow down the heart rate, overlap, often help identify. (D) supraventricular tachycardia, the vagus nerve stimulation if there is atrioventricular block, then the tachycardia or sinus node reentrant tachycardia, bypass can be ruled out and most of the atrioventricular nodal reentry.