急性颅脑损伤心电图改变的临床研究

目的:探讨急性颅脑损伤程度及预后与心电图变化的关系。方法:对159例颅脑损伤患者均经CT确诊,并在伤后24h内行心电图检查,第7、14、21天复查。结果:GCS评分13～15分患者中有32.3%出现心电图异常,GCS评分8～12分患者中有78.5%出现心电图异常,GCS评分<7分患者中百分之百出现心电图异常,其中,随着颅脑损伤病情的稳定好转而心电图异常也随着好转者占96.7%。结论:心电图异常对估计心脏损害、颅脑损伤的程度和预后评估均有重要的指导意义,颅脑损伤后出现心电图异常改变提示病情危重及预后不良。

The clinical research of the relation between the electrocardiogram's change and acute craniocerebral injuries

Objective： To explore the relation between the electrocardiogram＇ s change and acute craniocerebral injuries . Methods： The electrocardiogram（ECG） was taken down immediately after admission and was reexamined on the 7th,14th and 21th days after the admission in 159 patients with acute craniocerebral injuries, of whom, 34 suffered from mild cranioeerebral injuries, 65 from moderate and 60 from severe. Results： There were the abnormal ECG, including myocardial ischemia and arrhythmia, in 121 of 159 patients with acute craniocerebral injuries. Of 121 patients with abnormal ECG, 11 （32. 3%） had mild craniocerebral injuries, 51 （78. 5%） moderate and 60 （100%） 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 3 weeks after the injuries was observed in the patients with acute craniocerebral injuries accompanied with abnormal ECG. Conclusion： The abnormal ECG may be induced by the acute eraniocerebral 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 ECG is helpful to estimate the condition of injuries.