【摘要】 目的　报道 3例高钾血症引起的复杂心电图改变。方法　对临床心电图和血钾化验结果进行对照分析。结果　 3例患者血钾均明显升高。例 1系慢性房颤患者 ,血钾 8 5 0mmol/L出现窦 -室传导、室内 (左前分支、心室肌 )阻滞 ;例 2血钾 7 84mmol/L时出现窦 -室传导 ,随血钾进一步升高出现窦 -室传导的文氏现象 ;例 3血钾 9 75mmol/L出现心脏多部位 (心房、房室、右束支、左前分支、心室肌 )阻滞。结论　高钾引起心房肌、心室肌传导阻滞的同时 ,部分患者可伴有房室阻滞、束支阻滞、分支阻滞 ,在慢性房颤中亦可发生窦 -室传导 ,在窦 -室传导中同样可发生Ⅱ度阻滞 ,提高对这些复杂心电图的认识有助临床意义分析更多还原

【Abstract】 Objective This article reports three cases of complex ECG changes caused by hyperkalemia. Methods Compared with the serum potassium concentration, the ECG changes of three cases were analyzed. Results The serum potassium concentration in three patients were all increased. Case 1 was chronic atrial fibrillation. When the serum potassium concentration was 8.50 mmol/L, the ECG showed sino-ventricular contruction, anterior hemiblock, ventricular myocardium block.The serum potassium concentration in case 2 was 7.84 mmol/L. The ECG showed sino-ventricular contruction, and Wenckebach phenomena of sino-ventricular contruction with the increase of the serum potassium concentration. The serum potassium concentration in case 3 was 9.75 mmol/L. The ECG showed many parts block of heart(atrial, atrio-ventricle, right bundle branch, left anterior fasciculus, ventricular myocardium ). Conclusions The ECG in patients with hyperkalemia may show atrial myocardium, ventricular myocardium block, simultaneously may accompany by atrio-ventricular block, bundle branch block and fascicular block for some patients. The patients with chronic atrial fibrillation may generate sino-ventricular conduction, and second degrade block of sino-ventricular conduction. To recognize these complex electrocardiographic manifestations of hyperkalemia is to help the analysis of clinical significance.更多还原