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目的探讨重型颅脑损伤后不同颅内压水平对心电图的影响。方法 2010年3月至2014年3月122例重型颅脑损伤患者根据不同颅内压水平分为3组:颅内压维持20~30mm Hg、颅内压维持在30~40mm Hg、颅内压>40mm Hg,所有患者伤后24小时内经标准12导联心电图检查,应用SPSS 13.0统计学软件分析相关结果。结果 122例重型颅脑损伤患者心电图异常81例,占66.4%,3组之间异常心电图差异主要反映在异常Q波、QT间期延长、ST-T变化、窦性心动过缓及过速(p<0.05),并与颅内压水平成正相关,而在心律失常及传导阻滞方面的差异无统计学意义(p>0.05)。结论颅脑损伤后出现的异常心电图可作为初步评估损伤程度的参考指标,对患者病情的判断以及为医师提供诊疗参考具有一定的临床意义。
Objective To investigate the effect of different intracranial pressure on electrocardiogram after severe craniocerebral injury. Methods From March 2010 to March 2014, 122 patients with severe craniocerebral injury were divided into three groups according to different intracranial pressure: intracranial pressure maintained at 20-30 mm Hg, intracranial pressure maintained at 30-40 mm Hg, intracranial pressure > 40mm Hg, all patients within 24 hours after injury by standard 12-lead ECG, the application of SPSS 13.0 statistical software analysis of the relevant results. Results There were 81 cases of electrocardiogram abnormalities in 122 cases of severe craniocerebral injury, accounting for 66.4%. The abnormal electrocardiogram differences among the three groups were mainly reflected in abnormal Q waves, QT prolongation, ST-T changes, sinus bradycardia and tachycardia p <0.05), and with a positive correlation with intracranial pressure, but no significant difference in arrhythmia and conduction block (p> 0.05). Conclusion Abnormal electrocardiogram after craniocerebral injury can be used as a preliminary index to evaluate the degree of injury. It is of clinical significance to judge the condition of the patients and to provide reference for clinicians.