目的:探讨危重患者动态心电图(DCG)监测的临床意义.方法:选择我院2007年8月至2009年10月危重症患者206例,其中冠状动脉粥样硬化性心脏病(冠心病)65例,急性心肌缺血(SIM)38例,高血压病25例,晚期肺癌31例,呼吸衰竭25例,脑血管意外22例.入院后先行常规心电图(ECG)检查,然后进行24h DCG监测,同时对日常活动、情绪变化及所出现的症状进行记录.结果:DCG 检测心律失常的总检出率高达99.5%,而ECG为51.3%,两者比较差异有统计学意义(P<0.05).ECG和DCG心肌缺血检出率分别为54.9%和44.2%,两者比较差异有统计学意义(P<0.05).结论:DCG可提高心律失常、心肌缺血,特别是恶性心律失常和SMI的检出率,而且易于为患者接受,值得临床推广.%Objective: To disscuss the clinical significance of dynamic electrocardiogram ( DCG ) monitorring in critically patients. Method: We choosen 206 cases of critically patients in our hospital from August 2007 to October 2009, including 65 cases coronary heart disease ( CHD ) , acute myocardial ischemia ( SIM) 38 cases, hypertension 25 cases, advanced lung cancer 31 cases, respiratory failure 25 cases, cerebral vascular accident 22 cases. First routine electrocardiogram ( ECG ) examination were done after incharge, and then did DCG monitoring for 24 hours, meanwhile, recorded the daily activities, mood changes and the symptoms. Result: DCG total detection rate of arrhythmia detection was up to 99.5％, but the ECG was 51.3％, there's significant difference between them ( P ＜0.05 ). The detection rate of myocardial ischemia in ECG and DCG were 54.9％ and 44.2％, the difference was statistically significant ( P ＜0.05 ).Conclusion: DCG can improve the detection rate of cardiac arrhythmia, myocardial ischemia, especially in malignant ventricular arrhythmia and SMI, It is worthy of clinical applying.
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