摘要
分析急性肺栓塞的临床表现及心电图早期特征变化情况.方法 选取我院2021年1月至2023年1月收治的120例疑似急性肺栓塞患者为研究对象,分析其发病的症状、心电图早期特征.结果 急性肺栓塞患者呼吸困难、心悸、胸痛、咯血占比明显高于普通肺病(P＜0.05),咳嗽、发热、晕厥发生率和普通肺病差异无统计学意义(P＞0.05).早期心电图特征检查显示,急性肺栓塞患者胸前导联ST-T改变、中-重度顺钟向转位、肺型P波、心电轴右偏＞110°、典型SIQ Ⅲ T Ⅲ者占比明显高于普通肺病患者(P＜0.05),而Ⅰ avL导联有S波、Ⅲ avF导联有Q波,Ⅱ导联无Q波、不完全或者完全性右束支传导阻滞者占比和普通肺病患者差异无统计学意义(P＞0.005).1例房性期前收缩患者死亡,其他患者存活,患者死亡率为1％.老年患者中合并糖尿病、高血压、冠心病、心房颤动者比例明显高于非老年患者(P＜0.05),且老年患者胸痛、咳嗽发生率明显高于非老年患者(P＜0.05).结论 急性肺栓塞是临床中常见的急症,其具有常见的临床症状和典型的临床表现,肺栓塞需要及时进行心电检查,必要时结合动脉血气分析、超声心动等检查,进一步明确其病情,避免出现漏诊、误诊.
Abstract
Objective To analyze the symptoms and early changes in electrocardiogram characteristics of acute pulmonary embolism.Methods A total of 120 suspected acute pulmonary embolism patients admitted to our hospital from January 2021 to January 2023 were selected as the research subjects,and their onset symptoms and early electrocardiogram characteristics were analyzed.Results The proportion of dyspnea,palpitations,chest pain,and hemoptysis in patients with acute pulmonary embolism was significantly higher than that in patients with ordinary lung disease(P＜0.05).The incidence of cough,fever,and syncope was not significantly different from that in patients with ordinary lung disease(P＞0.05).Early electrocardiogram examination showed that the proportion of ST-T changes in chest leads,moderate to severe clockwise transposition,pulmonary P-wave,right deviation of electrocardiogram axis＞110°,and typical SIQ Ⅲ T Ⅲ in patients with acute pulmonary embolism was significantly higher than that in patients with ordinary lung disease(P＜0.05).However,there was no significant difference in the proportion of patients with Ⅰ avL with S-wave,Ⅲ avF with Q-wave,Ⅱ without Q-wave,incomplete or complete right bundle branch block compared to patients with ordinary lung disease(P＞0.05).One patient with atrial premature contractions died,while the other patients survived,with a mortality rate of 1％.The proportion of elderly patients with diabetes,hypertension,coronary heart disease and atrial fibrillation was significantly higher than that of non-elderly patients(P＜0.05),and the incidence of chest pain and cough in elderly patients was significantly higher than that in non-elderly patients(P＜0.05).Conclusion Acute pulmonary embolism is a common emergency in clinical practice,with common clinical symptoms and typical clinical manifestations.Pulmonary embolism requires timely electrocardiogram examination,combined with arterial blood gas analysis,echocardiography,and other examinations if necessary,to further clarify its condition and avoid missed diagnosis and misdiagnosis.
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