包健敏

[摘要] 目的 分析房室交界性逸搏伴束支文氏现象的心电图特点，探讨诊断可行性，为临床诊治疗提供依据。方法 方便选取2015年9月—2017年6月于该院进行治疗的20例房室交界性逸搏伴束支文氏现象患者和20例窦性心律失常患者为研究对象，分别作为研究组和对照组，对两组患者心电图资料进行回顾性分析，并对比两组患者比心电图特点。结果 研究组患者QRS波变化率（100.00%）显著高于对照组（5.00%），差异有统计学差异（χ2=36.19，P=0.000）；研究组患者心电图出现逆行P'波率（95.00%）显著高于对照组（5.00%），差异有统计学差异（χ2=32.40，P=0.000）。 结论 房室交界性逸搏伴束支文氏现象患者心电图会出现QRS波“手风琴”样变宽，QRS波前后出现逆行P'波等特征性变化，心电图可作为该病病情判断和预后进展的重要评价指标，具有良好的临床运用和推广价值。

[关键词] 房室交界；逸搏心率；文氏现象；心电图特点

[中图分类号] R540.41 [文献标识码] A [文章编号] 1674-0742（2018）08（b）-0163-03

Analysis of Conventional Electrocardiogram Results of Atrioventricular Junction Evoked with Bundle and Venturi

BAO Jian-min

Department of Cardiology， the Third Peoples Hospital of Hubei Province， Wuhan， Hubei Province， 430030 China

[Abstract] Objective To analyze the electrocardiographic characteristics of the Ventricular atrioventricular junction escapement bundle branch Wenshi phenomenon and explore the feasibility of diagnosis to provide the basis for clinical diagnosis and treatment. Methods Twenty patients with atrioventricular junctional escape syndrome and bundles of Wenshi phenomenon who were treated in the hospital from September 2015 to June 2017 were convenient selected as the study group and 20 patients with sinus arrhythmia as the control group. The ECG data of the two groups were analyzed retrospectively， and the characteristics of the two groups of patients were compared with the electrocardiogram. Results The rate of change of QRS waves in the study group （100.00%） was significantly higher than that of the control group（5.00%）， with statistical significance （χ2=36.19， P=0.000）； the electrocardiogram of the study group had a retrograde P′ wave rate （95.00%）， significantly higher than the control group （5.00%） with a statistical difference （χ2=32.40， P=0.000）. Conclusion There are QRS complexes with wide "accordion" like QRS complexes and retrograde P' waves before and after QRS complex. ECG can be used as judgement and prognosis of the disease. The important evaluation indicators have good clinical application and promotion value.

[Key words] Atrioventricular junction； Escape heart rate； Wenshi phenomenon； ECG characteristics

近年来，由于人們生活节奏加快，生存压力变大，心脏病的发病率呈逐年上升趋势，心脏病已经成为威胁人类生命的重大疾病之一。心律失常是临床上的一种常见心脏疾病，严重的心律失常会危及患者生命，预后不良。心电图（ECG）可直接记录心脏搏动过程的微弱电流变化规律，是心律失常的重要诊断依据，其优点是无创、快速、准确，对于临床诊断和治疗有重要意义[1]。一个正常典型的心电波形通常包括QRS波、P波、U波、T波以及各间期，分别代表心脏不同部位进行的电生理活动，心律失常患者的心电波会发生不同程度的改变[2]。……