目的:探讨超声心动图联合心电图对妊娠中期心脏畸形胎儿的诊断价值.方法:回顾性分析我院2019年1月到2021年1月出生后确诊与尸检确诊为心脏畸形的80例胎儿的临床相关指标,分析80例胎儿超声心动图检查与胎儿心电图检查结果,并分析超声心动图联合心电图对妊娠中期心脏畸形胎儿的诊断价值.结果:80例胎儿有56例出现不同程度的心电图异常现象,其中胎心早搏3例、FQRS振幅增高12例、ST段改变15例、FQRS时限增宽3例、胎心不齐4例、胎心过缓3例、胎心过速16例;80例胎儿通过尸检和出生后随访最终确定左心发育不良综合征(HLHS)4例,单心室6例,完全性心内膜垫缺损(ECD)8例,法洛四联症(TOF)14例,卵圆孔直径大于6mm17例,室间隔缺损(VSD)31例,与超声心动图诊断结果对比无显著差异(P＞0.05),超声心动图有7例漏诊;联合诊断与超声心动图和心电图对左心发育不良综合征、单心室、完全性心内膜垫缺损胎儿的诊断对比无明显差异(P＞0.05),对法洛四联症、卵圆孔直径大于6mm、室间隔缺损和心脏畸形诊断总数方面联合诊断优于超声心动图和心电图单一诊断(P＜0.05);通过不同检查的检测价值对比发现,超声心动图联合心电图检查的准确度、敏感度、特异度、阳性预测值和阴性预测值明显高于超声心动图与心电图单一检查.结论:超声心动图和心电图对于妊娠中期心脏畸形胎儿的诊断均具有重要价值.心脏畸形胎儿在妊娠中期进行心电图检查会出现异常现象,但是并不能确诊为心脏畸形,还需后续继续应用超声心动图进行检查,最终确诊胎儿是否存在心脏畸形现象.
患者女性，38岁，入院诊断“孕3产1，宫内妊娠39+6周，孕LOA，中度贫血”。既往无高血压病史。入院体检：体温36.1℃，呼吸20次/min，心率80次/min，血压120/80mmHg，心律齐，各瓣膜听诊区未闻及病理性杂音。双肺呼吸音清，未闻及杂音。心电图检查正常（图略）。患者血常规示血浆总蛋白57.2 g/L （正常值65～80 g/L），白蛋白26.4 g/L （正常值34～48 g/L），血红蛋白68 g/L （正常值110～150 g/L），入院后给予输血等治疗。
Objective To investigate the value of electrocardiogram in patients with hyperkalemia in emergency rescue.Methods The clinical data of electrocardiograms in 80 patients with hyperkalemia in emergency rescue in our hospital from January 2009 to February 2011.Results There are 46 patients with abnormal electrocardiogram,the detective rate was 57.5%.Among them,acute or chronic renal insufficiency was 27 cases(58.7%),then the diabetes in 7 cases(15.2%).The level of serum potassium concentration was 5.0 to 7.0 mmol/L,the detective rate was 27.3%.High wave of sharp T,S wave-amplitude was broaded,P wave-amplitude was reduced by ECG feature..When the level of serum potassium was more than 7.0 mmol/L,the detective rate was 76.0%.T wave was tall,peaked and tended,P-R stage was extended,P wave was low amplitude or absent,and ST segment moved down,QRS complex widened by ECG feature.Conclusion With the level of serum potassium increased,the incidence of abnormal changes of electrocardiogram is higher,and is of clinical significance in distinguish hyperkalemia and pseudo-hyperkalemia.
动态心电图(ambulatory electrocardiogram,AECG)是美国物理学博士、实验物理学家Normen J.Holter于1957年发明的,故又称Holter心电图(Holter ECG),简称Holter.AECG仪一次可记录24 h或更长时间的动态心电活动信息,为心血管疾病的诊断提供了重要的检测手段.1978年,解放军总医院黄大显教授率先将AECG技术引入我国,并开展了AECG的研究和临床应用.
目的:探讨冠心病无症状心肌缺血的动态心电图特点。方法:回顾性分析我院2009年1～12月无胸闷胸痛动态心电图检测到无症状心肌缺血的门诊及住院患者42例临床资料。结果:42例中共检出缺血发作252次,每例发作1～31次,平均6次。结论:动态心电图是对无症状心肌缺血最简单、无创性检测方法之一,为冠心病无症状心肌缺血诊断提供了依据。
提出动态心电图(AECG)在自动识别心律失常方面存在的几个问题,并提出了人工对话编辑解决问题的具体方法。
Objective Solve the wiring error,wiring twine and contamination.Methods Electrocardiogram conductor jointing device.The thesis stated the manufacturing process,usage and functions of the device.Results The device has completely solved the above problems.At the same time,it increased the lead wire life,reduced or even avoided the problems of electrocardiogram electrode ball sucking and missing electrode grips.As a result,the device can raise working efficiency and can be used as a dustproof mask of eletrocardiogram.Conclusions The device is worth popularizing in clinical practice for its simple manufacture,low cost,convenient use and multiple functions.
