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目的:分析急性肺栓塞患者早期心电图及诊断价值。方法:对我院近年来收治的60例急性肺栓塞患者进行溶栓抗凝治疗前、后心电图变化做回顾性分析。结果:在60例急性肺栓塞患者中,有50例存在18项不同程度的心电图表现异常:肺型P波、AVR导R波振幅提高、窦性心动过速、胸前导联T波倒置、S_1Q_MT_M、右束支阻滞等。通过溶栓抗凝治疗后,4例无明显变化,3例V1(或V_3R~V_5R)顿挫波消失,36例窦性心律减慢,3例室性早搏消失,2例AVR导R波振幅降低,3例房性早搏消失,1例心房颤动消失,9例胸前导联T波直立数增加,11例S_1Q_MT_M消失,10例QRS波电轴左移。结论:急性肺栓塞患者多存在心电图异常,主要特点是多样性、一过性、无特异性。分析心电图变化可对急性肺栓塞患者的早期危险进行分层,结合患者临床生命指标,以便更好地做出诊断和早期治疗干预,对再灌注疗效的评估和预后有重要意义。
Objective: To analyze the early electrocardiogram and its diagnostic value in patients with acute pulmonary embolism. Methods: A retrospective analysis of electrocardiogram changes in 60 patients with acute pulmonary embolism treated in our hospital in recent years before and after thrombolytic anticoagulation was performed. Results: Among the 60 patients with acute pulmonary embolism, there were 18 electrocardiogram abnormalities in 18 patients with varying degrees of pulmonary P wave, AVR R wave amplitude, sinus tachycardia, chest wave T wave inversion, S_1Q_MT_M, right bundle branch block and so on. After thrombolysis and anticoagulation therapy, there was no significant change in 4 cases, 3 cases of V1 (or V_3R ~ V_5R) frustration wave disappeared, 36 cases of sinus rhythm slowed down, 3 cases of ventricular premature beats disappeared, 2 cases of AVR guided R wave amplitude decreased , 3 cases of atrial premature beats disappeared, 1 case of atrial fibrillation disappeared, 9 cases of thoracic aorta T wave increased, 11 cases of S_1Q_MT_M disappeared, 10 cases of QRS wave axis shifted to the left. Conclusion: There are many ECG abnormalities in patients with acute pulmonary embolism, the main features are diversity, transient, non-specific. Analysis of ECG changes can stratify early-stage risk in patients with acute pulmonary embolism, combined with clinical life parameters in order to make better diagnosis and early treatment intervention, evaluation and prognosis of reperfusion efficacy of great significance.