目的:观察门诊患者体外反搏康复过程中,对心律失常和心率进行便携式心电监测的价值。方法对比268例高血压患者在接受体外反搏康复治疗前、中、后便携式心电监测和血压监测的结果,并与常规心电图记录进行比较。结果共收到患者在体外反搏治疗前、中、后监测心电图1658条,其中有效图形1576条,占95.1%。便携式心电监测仪监测到心律失常心电图133条,检出率为25.4%(68/268);常规心电图检查出心律失常33例,检出率为12.3%(33/268),两者比较,差异有统计学意义(P<0.01)。体外反搏治疗后心率[(68.84±10.79)次/min]比治疗前[(74.04±11.48)次/min]降低,差异有统计学意义(P<0.001);收缩压治疗后[(124.99±12.68) mmHg ]比治疗前[(129.67±12.17) mmHg ]降低,差异有统计学意义(P<0.001);舒张压治疗后[(72.73±7.19)mmHg]比治疗前[(74.06±8.23)mmHg]降低,差异有统计学意义(P<0.01)。结论便携式心电监测可以观察门诊患者体外反搏康复治疗过程中心率的变化并记录心律失常,方便且实用。心律失常检出率高于常规心电图检查。
Objective To discuss the clinical value of portable remote ECG monitoring for ar-rhythmia and heart rate during outpatients'recovery of external counterpulsation ( ECP) .Methods For the enrolled 268 outpatients , the results of portable ECG monitoring and blood pressure monito-ring were compared before , during and after ECP , and also compared with the results recorded by routine ECG.Results We collected 1 658 strips of ECGs in all monitored before , during and after ECP, including 1 576 valid ones, accounting for 95.1%.Arrhythmia was detected out of 133 strips of ECGs by portable remote ECG monitoring , with a detection rate of 25 .4%( 68/268 ) , while 33 cases with arrhythmia were detected by routine ECG , with a detection rate of 12 .3% ( 33/268 ) . The difference of detection rates in the two methods was statistically significant (P〈0.01).After the treatment of ECP, the patients'heart rates[(68.84 ±10.79) beats/min] were slowed down than be-fore[(74.04 ±11.48) beats/min], with statistically significant difference (P〈0.001).After the treatment of systolic blood pressure , their heart rates[(124.99 ±12.68) mmHg] were slowed down than before[(129.67 ±12.17) mmHg], with statistically significant difference (P〈0.001).After the treatment of diastolic blood pressure , their heart rates [ ( 72 .73 ±7 .19 ) mmHg ] were slowed down than before[(74.06 ±8.23) mmHg], with statistically significant difference (P〈0.01). Conclusion The portable remote ECG monitoring can be applied in observing the changes of heart rate and recording electrocardiosignals of arrhythmia .The method proves to be convenient and practical.The detection rate of arrhythmia is higher than that of routine ECG examination .