恶性快速性室性心律失常致心脏骤停的临床观察.docVIP

恶性快速性室性心律失常致心脏骤停的临床观察 恶性快速性室性心律失常致心脏骤停的临床观察 作者：林加锋 作者单位：温州医学院附属第二医院心内科，浙江温州 325027 【摘要】 目的 探讨恶性快速性室性心律失常致心脏骤停的原因与高危心电表现。方法 分析45例在入院时或入院后至少发生1次心脏骤停患者的原因及其发作时与发作前后的常规12导联心电图或持续心电监视心电图形。结果 45例恶性快速性心律失常致心脏骤停最常见的基本原因为冠心病急性或陈旧性心肌梗死，次为特发性及继发性巨大异常J波、扩张型心肌病；低钾血症是最常见的诱因；最常见的恶性快速性室性心律失常类型是心室颤动。其高危心电图表现：①复杂性室性早搏；②异常J波；③继发性长Q_T间期综合征；④Brugada综合征；⑤广泛前壁心肌梗死伴墓碑样ST段抬高。上述各种原因心脏骤停者有各自不同的临床及心电学特征。结论 恶性快速性室性心律失常所致心脏骤停存在多种原因及高危心电图表现。 【关键词】 心律失常 心脏骤停 心电描技术 Clinical Observation of Cardiac Arrest Caused by Malignant Rapid Ventricular Arrhythmia. LIN Jia-feng, LI Ji-wu, JI Kang-ting, et al. The Second Affiliated Hospital of Wenzhou medical college, Zhejiang 325027, China ［Abstract］ Objective To explore causes and high risk electrocardiogram expression of cardiac arrest caused by malignant rapid ventricular arrhythmia. Methods Study included 45 patients, who had cardiac arrest once or more after admitted to hospital. Results The basic causes of cardiac arrest in 45 patients were as follows: 1) coronary heart disease with acute or outmoded myocardial infarction; 2) secondary and idiopathic abnormal vast J wave, dilated cardiomyopathy; 3) other causes. Hypokalemia was the most ordinary inducer. Ventricular fibrillation(VF) was the most common type of malignant rapid ventricular arrhythmia. They had some high risk electrocardiogram expressions: 1) complex ventricular ectopic beats; 2) secondary and idiopathic abnormal J wave; 3) secondary long Q-T syndrome;4) Brugadas syndrome; 5)extensive anterior myocardial infarction with tombstone ST segment elevation. The patients had different electrocardiographic and clinical characteristics. Conclusions The cardiac arrest caused by malignant rapid ventricular arrhythmia had different causes and high risk electrocardiogram expressions. ［Key words］ Arrhythmia; Cardiac arrest; Electrocardiogram 为探讨恶性快速性室性心律失常致心脏骤停患者的原因及高危心电图表现，对45例恶性快速性心律失常致心脏骤停的原因及心电图进行前瞻性研究，旨在探讨与心脏骤停发作相关的基本病因、诱因、心电学表现及转归，并提出防治措施。