急性颅脑损伤后的动态心电图变化及分析

目的探讨急性颅脑损伤后心电图改变,了解心肌损害情况。方法入院后即行24h动态心电图描记,1周及2周时复查。结果本组206例急性颅脑损伤患者中,170例出现心电图异常(82.5%),其中重型颅脑损伤组108例(92.3%),中型组51例,轻型组11例(40.7%)。心电图异常主要表现为心肌缺血性改变和心律失常。绝大多数患者心电图改变在2周内随着伤情的好转而恢复正常。结论颅脑损伤可引起心电图异常变化,且其变化与损伤程度呈正相关。心电图改变可反映急性颅脑损伤后心肌损害程度,为临床早期判断伤情提供依据。

Change in Dynamic Electrocardiogram and Analysis of Its Significance in Patients with Acute Craniocereebral Injuries

Objective To explore the change in dynamic electrocardiogram (ECG) and to understand the myocardial injury in the patients with acute craniocerebral injuries. Method The dynamic ECG was taken down immediately after admission to the hospital and was reexamined on the 7th and 14th days after the admission in 206 patients with acute craniocerebral injuries, of whom, 27 suffered from mild craniocerebral injuries, 62 from moderate and 117 from severe. Results There were the abnormal ECG, including myocardial ischemia and arrhythmia, in 170 of 206 patients with acute craniocerebral injuries. Of 170 patients with abnormal ECG, 11 (40.7%, 11/ 27) had mild craniocerebral injuries, 51 (82.3%, 51/62) moderate and 108 (92.3%, 108/117) severe. The rate of the abnormal ECG was significantly higher (P<0.05) in the patients with severe craniocerebral injuries than that in the patients with moderate craniocerebral injuries, in whom the rate of the abnormal ECG was significantly higher (P<0.01) than that in the patients with mild craniocerebral injuries. The return of the ECG to normal within 2 weeks after the injuries was observed in the patients with acute craniocerebral injuries accompanied with abnormal ECG while their brain injuries mended. Conclusions The abnormal ECG may be induced by the acute craniocerebral injuries, and its change is positively related to the degree of severity of craniocerebral injury. The change in ECG can reflect the degree of myocardial damage. The recording of dynamic ECG is helpful to estimating the condition of injuries.