慢性肺心病心律失常临床特征.docVIP

慢性肺心病心律失常临床特征 　 作者：黄林锋 温文川 王玫 林广玲 【关键词】 肺心病 摘 要：目的:探讨肺心病心律失常的临床特征及治疗原则。方法:本组病例总共136例，全部于入院后48h内通过24h心电监护或反复常规12导联心电图检查，及时地发现心律失常类型并加以分析。结果:本组肺心病患者合并心律失常率达67.64%(92例)，其心律失常类型以房性心律失常最多，占42.08%，其次为窦性心动过速及室性心律失常。严重心律失常如室上性心动过速、多源室早、房室传导阻滞、房扑等也常出现。心律失常的出现及严重程度与患者病情的严重程度相关性明显，如心衰程度、肺部感染、低氧血症、水电解质紊乱等密切相关。结论:肺心病心律失常发生率较高，且与肺心病患者病情严重程度密切相关，而心律失常治疗应通过积极的病因及合并症治疗，使用抗心律失常药物不是最佳办法。 关键词： 肺心病; 心律失常; 心电图描记法 The Clinical Therapy and Features of Arrhythmias in Patients with Pulmonary Heart Disease Abstract： Objective: To study the clinical therapy and features of arrhythmias in patients with pulmonary heart disease. Method: Clinical data, electrocardiogram and dynamic electrocardiogram, classification of arrhythmia and therapy of 136 cases of patients with pulmonary heart disease were collected and analyzed. Result: Of 136 cases patients with pulmonary heart disease, there were 92 cases (67.64%) with arrhythmias. The main classification of arrhythmia were atrial arrhythmia(42.08%), sinus tachycardia and ventricular arrhythmia, in addition superventrical tachycardia, polymorphic ventricular premature beat, atrioventricularonary heart disease patiens with clinical variables［J］ .Am J Cardial，1994，23：753-756. block, atrial flutter. The pulmonary heart disease with arrhythmias was closely related to heart failure, lung function, water- electrolyte disturbance.Conclusion: The incidence of arrhythmia was high in patients with pulmonary heart disease. The severity of arrhythmia was positive relation to the severity of pulmonary heart disease. The therapy of pulmonary heart disease and the complication can be efficient to improve the arrhythmias. Key words: Pulmonary heart disease; Arrhythmia； Electrocardiography 慢性肺心病(简称：肺心病)是临床常见病，是中老年人死亡原因之一，死亡率高［1］合并症多，属于一种不可逆性全身多脏器功能障碍性疾病，临床可出现多脏器损害的表现，其中心律失常是其失代偿期的常见表现之一，发生率高达45～95%［2，3］。其发生与多种因素有关。现报道如下： 1 对象和方法 1.1 诊断标准：依据1998年第三次全国呼吸病会议修订的诊断标准，选择符合该诊断标准的肺心病患者136例，其中男103例，平均年龄58±10.92岁；女33例，平均年龄59±11.21岁。 1.2 仪器：心电监护仪，Holter心电图仪，常规十二导联心电图仪