冠状动脉旁路移植术围手术期心肌梗死的心电图特点.pdf

摘 要 结论 PMI 的心电图特点不仅包括指南所提及的新发生的左束支阻滞和新出现的 Q 波，在PM 各种类型的室内阻滞发生率均较未发生 PMI 的患者高；各种类型 的等位性Q 波均可能出现，且发生率较高；ST 段抬高多表现为相邻导联成组的 抬高。如表现为广泛抬高，除V1~V3 导联外抬高幅度多大于2mm 。 关键词： 冠状动脉粥样硬化性心脏病 冠状动脉旁路移植术 围手术期心肌梗 死 急性心肌梗死 心电图 III 万方数据 Abstract Abstract Background Coronary heart disease is one of the commonest cardiac diseases in the world. Coronary artery bypass grafting surgery (CABG) is a safe and effective procedure to relieve symptoms of angina, improve blood supply of myocardium, and reduce the incidence of myocardial infarctions. Periprocedural myocardial infarction is a severe complication with an incidence rate of approximately 2.5~5.0%. Risk factors of PMI include direct surgical injury, reperfusion-related oxygen free radical injury. PMI signify cantly prolongs recovery time, reduces quality of life, decreases survival rate, and increases costs of care. PMI can impacts cardiac function in a serious way when the affected areas are large, and may require additional surgeries. Early diagnosis is crucial to the management of PMI. Electrocardiograph is the one of the most convenient diagnostic method available in the clinic. Current ECG diagnostic criteria of PMI are established based on that of acute myocardial infarction. However, various factors contributes to nonspecific ECG changes in patients undergoing CABG, such as extracorporeal circulation, surgical injuries, post-surgical inflammatory reactions, electrolyte imbalance, etc., which perplex the clinician in making the right diagnosis.