摘要
目的：探讨危重患者动态心电图（ＤＣＧ）监测的临床意义。方法：采用国产ＪＨＹ１便携式动态心电监护仪对１９２例危重患者进行ＤＣＧ检测。结果：在常规心电图（ＥＣＧ）检查阴性的部分患者中，２４小时ＤＣＧ检测有心律失常、心肌缺血改变。而部分ＥＣＧ检查阳性者，ＤＣＧ发现更为严重的心律失常。ＤＣＧ发现心律失常的发生率及复杂性不仅与病种有关，而且与疾病的严重性有关。Ｌｏｗｎ分Ⅳ级室性心律失常主要发生在冠心病组患者和ＣＯＰＤ急性发作期组（分别为６４７１％和２６４７％）。同时亦观察到危重患者，特别是ＡＭＩ和心衰患者恶性心律失常的发生率明显较其他危重患者的发生率高（Ｐ＜０００５）。此外，心律失常的时间分布与心肌缺血、ＡＭＩ、猝死等事件的时间规律基本一致，反映神经内分泌调节昼夜节律性及其对心肌耗氧量和冠脉张力的影响。结论：ＤＣＧ是一种安全、无创、准确、可重复性强的检测方法，可提高心律失常和心肌缺血的检出率，能为临床医师提供重要信息。由于ＤＣＧ不能及时观察到危重患者的心电活动，已有明显严重心律失常患者不宜应用此种心电监测，而应采用床旁心电监测，以便能够及时观察心电变化，采取相应措施，改善患者预后。
Objective:To evaluate the significant of DCG monitoring in critical patients.Method:We performed 24h DCG monitoring in a group of 192 such patients.Result:During 24h DCG monitorng,We found more sever arrhythmia than during ECG detection,Ventricular arrhythmia is more frequent in CHD and COPD patients,severe arrhythmia is frequent in patients with acute myocadium infarction or heart failure( P <0 005),the time of episodes of arrhythmia and attack of myocardial ischemia,acute myocardial infarction,sudden death is correspondent,show nerve endocrines effection on myocardium moxygen consumption and tone of coronary artery.Conclusion:DCG is a secure,noninvasive,repeatable detective method,can provide the physician with precise clinical information.Owing to DCG cannot observe critical patients' cardiacelectrical activity in time,it is not used to monitor patients with severe ventricular arrhythmia.
出处
《河北医药》
CAS
1999年第1期8-10,共3页
Hebei Medical Journal
