8621例新兵復檢心電圖結果分析

楊麗娟 徐維明 李英杰

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8621例新兵復檢心電圖結果分析

楊麗娟 徐維明 李英杰

目的 分析新兵常規12導聯心電圖的特征及常見圖形表現，為新兵能否進一步參加高強度訓練提供參考。方法 對8621例新兵作常規12導聯心電圖檢查，根據心電圖檢查結果分類。結果 正常心電圖7038例（82%），竇性心動過緩957例，竇性心律不齊264例，竇性心動過速30例，左心室高電壓142例，T波波幅增高57例，一度房室阻滯17例，（不）完全性右束支阻滯28例，室性期前收縮23例，室上性期前收縮27例，ST-T改變11例，游走心律10例，早期復極波15例。11例ST-T改變中9例經心得安試驗ST-T恢復正常，957例竇性心動過緩中，948運動后心率＞90 次/min，30例竇性心動過緩中，27例經休息心理疏導后心率＜100 次/min，28例不完全性或完全性右束支阻滯經心臟彩超檢查排除先天性心臟病，57例T波波幅高大與神經功能失調相關，142例左心室高電壓經心臟彩超檢查排除心室肥大。結論 新兵入伍前經過嚴格篩選，故常規12導聯心電圖檢查多表現正常及正常范圍心電圖，部分新兵因訓練強度大，心理適應能力、生活方式改變等會造成心電圖圖形的改變，在判斷其異常心電圖及臨床意義時應審慎，以免造成新兵心理的壓力， 也為部隊以后的訓練做好風險評估。

12導聯心電圖；心律失常；新兵

[ Absract ]objective To provide references whether the new cruits could take high strength training after analyzing the characters and usual form of their general electrocardiograms.Methods 8621 new cruits had general 12-leads electrocardiograms detected ,then the electrocardiograms were classified. Results The electrocardiograms manifested as follow :normal in 7038 cases (82 percent), sinus bradycardia in 957 cases, sinus arrhythmia in 264 cases , sinus tachycardia in 30 cases ,left ventricular high voltage in 142 cases, the amplitude of T wave increased in 57 cases, Ⅰ°atrioventricular block in 17 cases, incompleted/completed right bundle branch block in 28 cases,ventricular premature contraction in 23 cases,supraventricular premature beat in 27 cases,ST-T changed in 11 cases, wandering rhythm in 10 cases,early repolarization wave in 15 cases. ST-T changing returned to normal in nine cases after propanolol test,the heart rate of 948 cases with sinus bradycardia increased to more than 90 beats per minute after exercise, the heart rate of 27 cases with sinus tachycardia decreased to less then 100 beats per minute after rest or psychological counseling,congenital heart diseases were ruled out in 28 cases with incompleted/completed right bundle branch block through echocardiogram inspection, the huge T wave in 57 cases were related to dysfunction of nervous system, ventricular hypertrophy were denied in 142 cases with left ventricular high voltage.Conclusion The general 12-leads electrocardiograms of new cruits were normal or in normal range,for they were screened rigorously before joining the army.The echocardiogram of some new cruits may changed because of high strength training,the changing of the ability of mental adaption and life style.You must be careful while judging abnormal echocardiogram and clinical value in order to avoid causing mental pressure to the new cruits.At the same time, risk assessment on the training of army later achieved.

[ Key words ] 12-leads electrocardiogram; arrhythmia; new cruits

新兵復檢十分重要，心電圖又作為必查項目有它的重要性和提示性。回顧分析近幾年8621名新兵常規12導聯心電圖檢查，現報告如下。

1 資料與方法

1.1 8621例新兵中，男性8553例，女性68例 ，年齡17～25歲，臨床無高血壓及心血管病史，聽診無病理性雜音，X線檢查心肺無異常，查體示發育良好。……