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目的:分析心电图改变在肺栓塞诊断中的临床价值。方法:病例选自我院住院的43例经CT、灌注/通气扫描或肺动脉造影明确诊断的肺栓塞患者,主要分析患者住院期间的临床表现及心电图特征性表现。结果:心电图改变者为97.7%,其中QIII占62.8%,窦速占55.8%,SI占41.9%,同时具备SIQIIITIII占32.6%,右束支阻滞占23.3%,ST-T段下移改变占53.5%,T波倒置特别以右胸导联为主,肺型P波仅占7.0%,顺钟向转位占18.6%,肢体导联低电压占9.3%、心房纤颤占2.3%,室性早搏占4.7%,正常心电图占2.3%。结论:心电图在肺栓塞的诊断方面虽然是非特异性和非诊断性的,但有许多特征对提示肺栓塞有一定的价值。
Objective: To analyze the clinical value of ECG changes in the diagnosis of pulmonary embolism. Methods: The patients were selected from 43 hospitalized patients with pulmonary embolism diagnosed by CT, perfusion / ventilation scan or pulmonary angiography in our hospital. The clinical manifestations and the characteristic electrocardiograms during the hospitalization were analyzed. Results: Electrocardiographic changes were 97.7%, QIII accounted for 62.8%, sinus speed accounted for 55.8%, SI accounted for 41.9%, with SIQIIITIII accounted for 32.6%, right bundle branch block accounted for 23.3%, ST-T segment changes accounted for 53.5%. T-wave inversion was dominated by the right thoracic lead. Pulmonary P wave only accounted for 7.0%, cis-transposition 18.6%, low limb lead voltage 9.3%, and atrial fibrillation 2.3% Premature beats accounted for 4.7%, 2.3% of normal ECG. CONCLUSIONS: Although ECG is nonspecific and non-diagnostic in the diagnosis of pulmonary embolism, there are many characteristics that have some value in suggesting pulmonary embolism.