心电图在急性肺栓塞诊断中的应用价值

目的探讨心电图在急性肺栓塞诊断中的应用价值。方法回顾性分析2008年1月～2010年1月在我院住院确诊的APE患者的心电图变化。结果溶栓加抗凝治疗65例，单纯抗凝治疗10例。治疗后病损肺段数减少（5．20±2．18）个。治疗前后行心电图检查，在溶栓后心电图变化的基础上，于出院前（约在溶栓3—4周）心电图又发生一些改变，如RⅡ增加，RⅢ减小，QⅢ减小；TⅢ变直立20例次，TV2直立12例次。结论肺栓塞的心电图变化为一过性、多变性改变，但仍有一些特征可循，所以要提高警觉、仔细分析、动态观察其心电图变化并结合临床特点和辅助检查作出正确的判断，提高心电图在急性肺栓塞诊断中的应用价值。

The application value of the electrocardiogram in the diagnose of Acute Pulmonary Embolism

Objective To investigate the application value of the electrocardiogram in the diagnose of acute pulmonary embolism.Methods Retrospectively analyzed the electrocardiogram’s change of the patients that diagnosed in our hospital from January 2008 to January 2010.Results All of 65 cases patients were treated by combining thrombolysis with anticoagulation,and 10 cases were treated alonly with anticoagulation.After the treatment,the number of damage of lung section reduced(5.20±2.18).Checked up the electrocardiogram before and after the treatment.On the base of the change of electrocardiogram after thrombolysis,the electrocardiogram changed again prior to discharge(about 3 to 4 weeks),for example,RⅡ increased,RⅢ decreased,QⅢdecreased,20 TⅢ turned up,12 TV2 turned up.Conclusion The electrocardiogram of the pulmonary embolism has temporary and polytropic change.But there are some features to be followed,so right judgment should be done by vigilant,careful analysis,the dynamic observe the changes of electrocardiogram and combined with clinical characteristics and auxiliary examination,to improve the application value of the electrocardiogram in the diagnose of acute pulmonary embolism.