发生电事故后的心律失常和实验室异常:对333例病例的单中心,回顾性研究
Miroslava Seyfrydova1, Richard Rokyta2, Daniel Rajdl3
1Department of Cardiology, University Hospital and Faculty of Medicine Pilsen, Charles University, Pilsen, Czech Republic. veselami@fnplzen.cz.
概括
电损伤可能会导致心律不整,但延迟心律不整很罕见. 无症状患者在电损伤后ECG正常,可能不需要持续监测.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 临床电生理学 临床电生理学
背景情况:
- 电击伤害在急救部门很常见,但欧洲缺乏具体的管理指南.
- 电损伤后的延迟心律不整是鲜为人知的,很少被记录下来.
- 对心肌损伤风险分层的心脏特异性标志物的实用性在电伤患者中需要进一步研究.
研究的目的:
- 追溯分析超过23年的电损伤病例,以确定心律失常的患病率,特别是恶性和延迟类型.
- 调查电伤患者恶性心律失常的潜在预测因素.
- 评估心脏特异性标志物和离子失衡在风险分层中的作用.
主要方法:
- 1997年至2020年在捷克普尔森大学医院诊断患有电击伤害 (ICD代码T754) 的患者的回顾性搜索.
- 从医院的信息系统和患者病历中提取数据.
- 分析初始的心电图发现,持续的心电图监测,心脏生物标志物和电解质水平.
主要成果:
- 确定了333起电伤病例;大多数是低压伤害.
- 心律不整发生在11.7%的患者中,心室动和鼻高心率最常见.
- 离子失衡 (低血,低血) 与心律失常有显著关联;热素升高是零星的,对风险分层没有帮助.
结论:
- 伤害后立即发生恶性心律不整;没有观察到延迟的危及生命的心律不整.
- 无症状的成人和儿科患者在电损伤后初始心电图发现正常,可以在没有持续监测的情况下出院.
- 对高风险患者或轻度心电图异常患者的管理建议需要进一步澄清.
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