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目的 探讨非心脏手术围手术期突发急性心肌梗死 (AMI)心电图某些指标与临床近期预后险恶特点。方法 自 1981年 1月至 2 0 0 0年 12月 ,我院收治围手术期AMI 4 9例 (Ⅰ组 ) ,另随机选择同期收治非手术住院AMI 6 0例 (Ⅱ组 )进行多项指标对照分析。结果 心电图指标PTFv1负值增大 ,ΣST段抬高及Q波导联数增多 ,QTc延长以围手术期见多 (P <0 0 5～P <0 0 1)。诱发AMI以情绪焦虑、疼痛、吸烟等。并以前壁或复合前壁AMI发生率高。发病时间 7∶0 0～ 12∶0 0及并发泵衰竭、恶性心律失常、心肌梗死扩展及病死率以围手术期AMI发生明显增多 (P <0 0 5 )。结论 围手术期AMI心电图指标明显异常 ,提示近期预后险恶尤为关注患者上午情绪稳定及有效止痛等防范措施
Objective To explore some of the indicators of acute myocardial infarction (AMI) electrocardiogram in perioperative non-cardiac surgery and the characteristics of clinical short-term prognosis. Methods From January 1981 to December 2000, 49 cases of AMI were treated in our hospital (group Ⅰ), and 60 cases of non-surgical AMI were randomly selected in the same period (group Ⅱ) Control analysis. Results The negative value of electrocardiogram index PTFv1 increased, ΣST segment elevation and Q wave number increased, QTc prolonged to see more perioperative (P <0 05 ~ P 0 01). Induced AMI with emotional anxiety, pain, smoking and so on. And the anterior wall or composite anterior wall AMI high incidence. The onset time was 7: 0 ~ 12: 0 0 and complicated with pump failure, malignant arrhythmia, myocardial infarction and mortality were significantly increased in perioperative AMI (P <0 05). Conclusions Perioperative AMI ECG abnormalities, suggesting that the recent prognosis is particularly concerned about the patient mood emotional stability and effective analgesic measures