心电图初步诊断恶性心包积液的临床价值

目的：探讨心电图在恶性心包积液初步诊断中的临床价值。方法回顾性观察149例恶性肿瘤患者心包积液的病因分布，并分析其心电图改变情况。结果恶性肿瘤合并心包积液患者以肺癌、乳腺癌及恶性淋巴瘤占多数。恶性心包积液患者窦性心动过速、胸／全导联低电压及 ST-T 改变的检出率显著高于良性心包积液患者，且差异有统计学意义（P ＜0．01）。结论当原发肿瘤患者出现上述心电图改变时，应高度怀疑合并恶性心包积液，可结合心脏彩超或 CT 等其他影像学资料进一步诊断。

Clinical value of ECG in presumptive diagnosis of malignant pericardial effusion

Objective To explore the clinical value of ECG in presumptive diagnosis of malig-nant pericardial effusion.Methods Retrospective analysis was performed on 1 49 malignant tumor patients complicated with pericardial effusion.The etiology distribution of pericardial effusion was observed and ECG changes were analyzed.Results The patients with lung cancer,mammary canc-er and lymphadenoma accounted for the majority of the 1 49 cases.Compared with the patients with benign pericardial effusion,the detection rates of nodal tachycardia,low voltage in chest/full leads and ST-T changes were significantly higher in the cases with malignant pericardial effusion,with sta-tistically significant differences(P <0.01 ).Conclusion The above ECG changes in primary tumor patients strongly suggest complicated malignant pericardial effusion.Other imaging data such as ul-trasonic cardiogram or CT should be combined with ECG for further diagnosis.