ECG心电图的解读.ppt

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1、ELECTROCARDIOGRAMTheFirstAffiliatedHospitalofShantouUniversityMedicalCollege卢成志TheStandard12-leadElectrocardiogramHowtomeasureeachwave:amplitudeduration25mm/sELECTROCARDIOGRAMECGrecordsthechangingpotentialofthefieldimpartedbytheheart.ECGdosenotrecorddirectlytheelectricalactivityoftheheart

2、.ECGrecordtheelectricalactivityoftheheartfromthebodysurface.插入离子通道图片ElectricalbasisandtheoryElectricalbasisandtheorydepolarizationdipolerepolarizationElectricalbasisandtheoryElectricalbasisandtheoryqClinicalelectrocardiolopyelementaryknowledgeVectorResultantvectorLoopElectricalbasisandthe

3、oryTheStandard12-leadElectrocardiogramSAnodeBachmannAVnodeHisbundleLeftandrightbranchofbundlePukinjefiberTheStandard12-leadElectrocardiogramPWaveP-RintervalQRSComplexSTsegmentTWaveQ-TintervalTheStandard12-leadElectrocardiogram——RWaveformLeadSystemoftheECGLimbleadsEinthoventrigoneHexaxial

4、systemLeadSystemoftheECGChestleadsChestleadsLeadSystemoftheECG.Ⅱ.ECGEVALUATIONTheStandard12-leadElectrocardiogramHowtomeasureeachwave:amplitudeduration25mm/sHowtocalculatetheheartrateHeartRate=60/R-RdurationMeanQRSaxisCardiacRotation.Ⅲ.NORMALECG⒈PWave⒉P-RInterval⒊QRScomplex⒋Jpoint⒌STSegme

5、nt⒍TWave⒎Q-TInterval⒏UWave.Ⅲ.NOMALECG——PWave⑴form：I、II、avF、V4-6⑵duration：<0.12s⑶amplitude:Limbleads<0.25mV,Chestleads<0.20mV..Ⅲ.NOMALECG——P-RIntervalduration：0.12s~0.20s..Ⅲ.NOMALECG——QRScomplex⑴duration:0.06~0.10s.⑵formandamplitude.⑶Rpeaktime⑷QWave.Ⅲ.NOMALECGJpointSTSegmentTWaveQ-TInt

6、ervalUWaveIV.TheAbnormalECGAtrialandVentricularhypertrophyAtrialandVentricularhypertrophy(一）atrialenlargmentLeftatrialenlargementRightatrialenlargement:AtrialandVentricularhypertrophy(一）leftVentricularenlargmentQRSvoltage:①RinV5,6>2.5mV,②RV5+SV1>3.5or4.0mV,③RI>1.5mV,RinaVL>1.2mV,aVF>2.0mV

7、,SinV12.4mV,④RI+SIII2.5mV.leftaxisdeviationQRSduration>0.09ms.STsegmentandTwaveleftVentricularenlargmentAtrialandVentricularhypertrophy(二）RightVentricularenlargment①V1leadR/S>1,V5leadR/S<1,②Rv1+Sv5>1.05mV.③rightaxisdeviation>+90°.④ST-TchangeRightVentricularenlargm