急性有机磷农药中毒105例心电图改变

目的 探讨心电图（ECG）对评估有机磷农药中毒患者中毒程度和预后的临床价值。方法 对105例有机磷农药中毒患者进行ECG检查，比较轻，中，重度中毒患者的心电图改变。结果 105例有机磷农药中毒患者中心电图异常者81例，占77.1%，无明显改变者24例，占22.9%。81例心电图改变以各类心律失常最多见，且以窦性心动过速占首位（44%），其次为ST-T改变（44%），Q-T间期延长（9%），心电图改变与中毒程度成正比。结论 ECG可作为判断急性有机磷农药中毒患者中毒程度和预后的指标之一。     

急性有机磷农药中毒心脏损害致心电图改变63例分析

目的　认识有机磷农药中毒后的心肌损害。方法　对 6 3例急性有机磷农药中毒后病人异常心电图进行分析总结。结果　急性有机磷农药中毒后可引起心肌损害 ,心电图表现为ST -T改变和各种心律失常。结论　急性有机磷农药中毒后引起心肌损害较常见。急诊救治过程中要给予充分认识。     

急性有机磷农药中毒105例心电图改变

目的　探讨心电图 (ECG)对评估有机磷农药中毒患者中毒程度和预后的临床价值。方法　对 10 5例有机磷农药中毒患者进行ECG检查 ,比较轻、中、重度中毒患者的心电图改变。结果　 10 5例有机磷农药中毒患者中心电图异常者 81例 ,占 77 1% ,无明显改变者 2 4例 ,占 2 2 9%。 81例心电图改变以各类心律失常最多见 ,且以窦性心动过速占首位(44 % ) ,其次为ST T改变 (44 % ) ,Q T间期延长 (9% )。心电图改变与中毒程度成正比。结论　ECG可作为判断急性有机磷农药中毒患者中毒程度和预后的指标之一。     

急性有机磷农药中毒患者心律失常156例临床分析

目的 探讨急性有机磷农药中毒患者的心律失常特点及其临床意义.方法 总结分析156例急性有机磷农药中毒患者的心律失常.结果 156例急性有机磷农药中毒患者中149例(95.5%)发生各种类型心律失常.其中窦性心律失常最常见(78例,占50%),其次为室性早搏(18例,占11.5%).死亡9例,其中5例(3.2%)与心律失常直接有关.痊愈出院时心律失常仅存10例(6.4%),与中毒期比较差异有统计学意义(P＜0.01).结论 急性有机磷农药中毒后可出现各种心律失常,早期认识并处理心律失常可减少死亡率.对有Q-T间期延长和室性心律失常出现,往往提示病情严重,预后不良.     

58例急性有机磷农药中毒的心电图改变

目的：了解急性有机磷农药中毒的心肌损害。方法：分析了58例急性有机磷农药中毒患的异常心电图。结果：58例急性有机磷农药中毒的心肌损害可表现为各种心律失常和ST－T改善，甚至会引起严重的恶性心律失常致猝死。结论：急性有机磷农药中毒致心肌损害常见且有时是致命的，临床需足够重视，积极诊治。     

96例急性有机磷农药中毒患者心肌损害

目的探讨急性有机磷农药中毒患者心肌酶学及心电图变化,了解其对心肌损害情况。方法对96例急性有机磷农药中毒患者（轻度中毒组41例、中度中毒组34例、重度中毒21例）入院后24 h内抽取空腹静脉血测定肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、乳酸脱氢酶（LDH）、α-羟丁酸脱氢酶（HBDH）、天门冬氨酸氨基转移酶（AST）,并常规描记体表心电图。结果急性轻度有机磷农药中毒患者血清心肌酶除CK外,余指标与正常对照组无显著性差异（P〉0.05）;中、重度中毒患者较正常对照组明显增高（P〈0.01）;急性有机磷农药中毒患者心电图可出现窦性心动过速、ST-T改变、房性早搏等变化。结论急性中、重度有机磷农药中毒患者存在心肌损害,中毒程度越深,心肌损害越重;同时有机磷中毒可致不同类型心电图改变。     

急性有机磷农药中毒程度与心电图异常的关系

目的探讨有机磷农药中毒程度与心电图异常的关系。方法对比分析有机磷农药中毒轻、中、重度患者心电图异常情况。结果103例急性有机磷农药中毒患者，其中轻度患者29例，心电图异常1例；中度患者41例，心电图异常20例；重度患者33例，心电图异常33例，经χ^2检验，差异有统计学意义（P〈0．01）。结论心电图异常与中毒程度有密切关系，心电图异常可以作为判断急性有机磷中毒患者中毒程度的参考指标之一。     

急性有机磷农药中毒65例临床心电图分析

对６５例急性有机磷农药中毒患者的临床表现及心电图改变进行对比、分析。发现心电图改变类型与中毒轻、重有关，检出异常心电图４６例（７０．８％），束支传导阻滞、ＳＴ－Ｔ段改变、心律失常是其主要表现。     

62例有机磷中毒的心电图分析

本文报道62例有机磷中毒的心电图表现。14例正常,48例异常,心电图异常与中毒程度成正比、异常心电图中,各类心律失常53例,ST-T改变28例,Q-T间联延长14例,2例发生扭转性室性心动过速继而室颤而猝死;除死亡者外,心电图变化随疾病痊愈而恢复。认为:对有机磷中毒应常规行心电图检查,对出现Q-T间期延长者,要高度警惕,行心电监护和给予及时处理,防止出现严重心律失常而猝死。     

急性有机磷农药中毒51例心电图分析

分析有完整心电图记录的急性有机磷农药中毒51例,出现异常心电图41例。可有心动过缓,心律失常,传导阻滞,P波、P—R间期、Q R S波异常,ST—T改变,Q—T、Q—T_c延长等。发现心律失常是有机农药中毒主要死因之一,P tf—V_1负值增大,多有心功能不全。Q—T越延长,心律失常发生率越高,预后越差;中毒越重,异常心电图越多,预后越差。提出急性有机磷农药中毒救治时常规记录心电图或心电监测对防治心律失常和中毒性心肌炎,提高治愈率有一定临床意义。     

Pattern of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital

Objective: This study was conducted to determine the pattern and severity of poisoning cases in Emergency Department of Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal (KMCTH). Design: Retrospective observational study. Materials and methods: Hospital records of all admissions to the Emergency Department of Kathmandu Medical College Teaching Hospital (KMCTH) following acute poisoning were revised and all data from February 2007 to February 2008 were analyzed retrospectively. Results: This retrospective observational study was performed on 148 cases of poisoning who attended Emergency Department of KMCTH over a period of one year. The overall male to female ratio was 1.05:1. Poisoning was most common in the age group 21-30 years (40.5%). The most common causes of poisoning in adults were organophosphorous compounds and in children was kerosene oil. Oral route (79.05%) was the most common route of administration. 66.2% of cases were intentional poisoning for suicidal attempt. Students (43.9%) and service holders (18.9%) were commonly involved in poisoning. Conclusion: It was seen that adult between 21-30 years of age were more prone to suicidal poisoning with organophosphorous compounds and children of 1-10 years of age were more susceptible to accidental poisoning with kerosene oil. Key words: Organophosphorous; Poisoning; Suicide; Kerosene.     

纤维支气管镜检查过程中的心电图监护

目的:探讨纤维支气管镜检查对心脏的影响。方法:进行纤维支气管镜检查前后常规描记十二导联心电图,检查中进行心电监护,在纤支镜到达隆突检查健侧肺、活检或刷检时描记Ⅱ导心电图。结果:152例患者术前、术中、术后始终保持正常者45例(29.6%)。术前心电图正常,术中术后出现异常者71例次(46.7%),以窦性心动过速最常见,活检及刷检时有56例次(78.8%),至术后迅速降至47.8%。术中出现室性早博3例次(4.2%),术后即消失。术中出现4例心肌缺血,术后有1例恢复。36例术前心电图异常中有14例术中术后均无变化。结论:纤支镜检查对心脏的主要影响是引起窦性心动过速、室性早博及心肌缺血,以活检及刷检时出现几率最高。利多卡因上呼吸道喷雾及气道内滴注,对心脏传导异常者是安全的。     

重症病毒性心肌炎--附48例分析并文献复习

目的分析重症病毒性心肌炎的诊断和治疗,旨在避免误诊,提高抢救成功率.方法对1999年5月～2003年5月收治的48例重症病毒性心肌炎患者的临床特点、心电图及诊治经过进行分析.结果本研究48例重症病毒性心肌炎患者中,39例(81.3%)首发临床表现均为胃肠道症状,4例(8.3%)为呼吸道症状,仅5例(10.4%)为心脏症状,呈现不典型性.心电图呈频发室早22例(45.8%),酷似广泛性急性心肌梗死早期图形10例(20.8%),短阵室速8例(16.7%),房室传导阻滞5例(10.4%),窦速伴T波或ST段改变3例(6.3%).病初误诊率85.4%.甲基泼尼松龙冲击治疗组存活率(96.7%)显著大于未使用甲基泼尼松龙的对照组(55.6%),P＜0.05.结论对临床上首发表现为非心脏症状而血流动力学异常的患者,应立即行心电图检查,任何形式的心电图异常均应立即考虑重症病毒性心肌炎的可能.甲基泼尼松龙冲击治疗可阻遏病情的恶化.     

Electrocardiographic abnormalities in aluminium phosphide poisoning with special reference to its incidence, pathogenesis, mortality and histopathology

Ninety-five patients out of total 190 cases of aluminium phosphide (ALP) poisoning, who exhibited ECG changes were studied for incidence, type and pattern of ECG abnormalities, their effect on mortality and their relationship with histopathology of heart. Its incidence in the present study was 50%. The arrhythmias, conduction disturbances and ischaemic pattern occurred more or less in equal frequency. Certain ECG abnormalities which had not been reported previously ie, early repolarisation syndrome, varied sino-atrial blocks, bradycardia-tachycardia syndrome and electrical alternans were observed in this study. The clinical profile of these cases was similar irrespective of whether patients had ECG abnormalities or not. Shock was the cardinal feature. There was no effect of ECG abnormalities on mortality. The mortality which was otherwise high, depended upon severity of poisoning, dose of poison consumed, duration of shock, failure of response of shock to resuscitative measures and severe hypomagnesaemia. The pathogenesis of ECG abnormalities is still obscure. Hypomagnesaemia was observed in all the 18 cases studied, irrespective of ECG abnormalities. However, these were common when hypomagnesaemia was severe. Hypoxaemia and shock were not the contributory factors for these abnormalities. Autopsy revealed stereotyped histopathological changes of toxic myocarditis independent of ECG findings.     

Carbon monoxide poisoning: a case report of reversible cardiormyopathy

Acute carbon monoxide poisoning is the most common cause of poison-related deaths in the U.S. A 21-year-old white woman was referred to Ruby Memorial Hospital after exposure to carbon monoxide (CO) from a faulty furnace. She developed acute weakness, dyspnea, nausea and vomiting. An electrocardiogram revealed sinus tachycardia, non-specific ST-T wave abnormalities, and a prolonged QTc interval. The chest X-ray revealed pulmonary edema and the 2-D echocardiography revealed decreased left ventricular systolic function with an ejection fraction of 25%. She was treated with high-flow oxygen and supportive medical therapy with complete resolution of the left ventricular dysfunction six weeks later. She has been followed for over one year without medical therapy and without recurrence of her symptoms. This case illustrates that the depressant effect of CO poisoning on the myocardium can be reversed in the short term with supportive medical therapy and recovery sustained in the long term without medical therapy.     

急性脑出血与脑梗死的临床心电图观察

目的:观察不同部位急性脑出血与脑梗死的心电图改变。探讨脑心综合征的发病情况。方法:选择126例急性脑出血及151例脑梗死患者的心电图资料,结合临床和CT、MRI分析其表现。结果:脑出血组窦性心动过速,左心室肥大和病死率明显高于脑梗死组,脑梗死组的窦性心动过缓并心律不齐,房颤和期前收缩的发生率明显高于脑出血组(P<0.05)。结论:脑出血、脑梗死的心电图异常与疾病严重程度密切相关。     

急性酒精中毒引起心脏损害80例临床分析

目的：对比分析急性酒精中毒者心电图、心肌酶变化，探讨不同程度急性酒精中毒与心脏损害的关系。方法：对203例中、重度急性酒精中毒患者做常规心电图、心肌酶检测，对其中80例心脏受损者进行心电图、心肌酶跟踪观察。结果：心电图异常发生率及心肌酶升高率随中毒程度而增高（P〈0．01）。传导阻滞发生率也随中毒程度加重而增加（P〈0．05），经及时治疗，心电图、心肌酶均恢复正常。结论：急性酒精中毒程度与心脏损害发生率及程度呈正比，急性酒精中毒对心脏损害，经积极治疗大多数是可逆的。但巾毒越重心电图、心肌酶恢复时间越长。     

538例青年女性健康体检心电图分析

[目的]了解22～31岁年龄段青年女性的心电图异常发生情况。[方法]采用日本光电9320K12导联心电图机同步描记,以郭继鸿主编的2002年版的《心电图学》为标准,分析538例青年女性健康体检的心电图结果。[结果]心电图异常者74例(13.8%)。其中,窦性心动过缓23例(31.1%),窦性心律不齐19例(25.7%),窦性心动过速15例(20.3%)。ST-T改变13例(17.6%)。室性期前收缩5例(6.8%),房性期前收缩2例(2.7%)。[结论]青年女性异常心电图以窦性心动过缓、窦性心律不齐、窦性心动过速、ST-T改变及期前收缩为常见。     

有机磷农药中毒用纳络酮治疗的作用探讨

目的 探讨纳络酮在治疗急性有机磷农药中毒的作用机制.方法 将急性有机磷农药中毒患者诊断及分析作一探讨.随机分为纳络酮治疗组和常规对照组.结果 纳络酮治疗组治愈率为97.5%,而对照组为84.6%,差异有统计学意义(P＜0.05).结论 急性有机磷农药中毒选用纳络酮可提高抢救成功率.