ECG心電圖的解讀ECG心電圖的解讀ECG心電圖的解讀ELECTROCARDIOGRAMECG心電圖的解讀ECG心電圖的解讀ECG心電圖的解讀ELEECG心電圖的解讀課件2ECG心電圖的解讀課件3ECG心電圖的解讀課件4ECG心電圖的解讀課件5插入離子通道圖片插入離子通道圖片6ElectricalbasisandtheoryElectricalbasisandtheory7ElectricalbasisandtheorydepolarizationdipolerepolarizationElectricalbasisandtheorydep8ElectricalbasisandtheoryElectricalbasisandtheory9ElectricalbasisandtheoryqElectricalbasisandtheoryq10Clinical

electrocardiolopyelementaryknowledgeVectorResultantvectorLoopClinicalelectrocardiolopyele11ElectricalbasisandtheoryElectricalbasisandtheory12TheStandard12-leadElectrocardiogramSAnodeBachmannAVnodeHisbundleLeftandrightbranchofbundlePukinjefiberTheStandard12-leadElectroca13TheStandard12-leadElectrocardiogramPWaveP-RintervalQRSComplexSTsegmentTWaveQ-TintervalTheStandard12-leadElectroca14TheStandard12-leadElectrocardiogram

——RWave

formTheStandard12-leadElectroca15LeadSystemoftheECGLimbleads

EinthoventrigoneHexaxialsystemLeadSystemoftheECGLimblea16LeadSystemoftheECGChestleads

LeadSystemoftheECGChestle17ChestleadsChestleads18LeadSystemoftheECGLeadSystemoftheECG19ECG心電圖的解讀課件20ECG心電圖的解讀課件21ECG心電圖的解讀課件22.Ⅱ.ECGEVALUATION

.Ⅱ.ECGEVALUATION23TheStandard12-leadElectrocardiogramHowtomeasureeachwave:amplitudeduration25mm/sTheStandard12-leadElectroca24HowtocalculatetheheartrateHeartRate=60/R-RdurationHowtocalculatetheheartrat25

MeanQRSaxisMeanQRSaxis26CardiacRotationCardiacRotation27.Ⅲ.NORMALECG⒈PWave⒉P-RInterval⒊QRScomplex⒋Jpoint⒌STSegment⒍TWave⒎Q-TInterval⒏UWave.Ⅲ.NORMALECG⒈PWave28.Ⅲ.NOMALECG

——PWave⑴form：I、II、avF、V4-6

⑵duration：<0.12s⑶amplitude:Limbleads

<0.25mV,Chestleads<0.20mV..Ⅲ.NOMALECG

——PWave⑴form：29.Ⅲ.NOMALECG

——P-RIntervalduration：0.12s~0.20s..Ⅲ.NOMALECG

——P-RInterval30.Ⅲ.NOMALECG

——QRScomplex

⑴duration:0.06~0.10s.⑵formandamplitude.⑶Rpeaktime⑷QWave.Ⅲ.NOMALECG

——QRScomplex

31.Ⅲ.NOMALECGJpointSTSegmentTWaveQ-TIntervalUWave.Ⅲ.NOMALECGJpointTWave32IV.TheAbnormalECG

AtrialandVentricularhypertrophyIV.TheAbnormalECGAtria33AtrialandVentricularhypertrophy

(一）atrialenlargmentLeftatrialenlargementRightatrialenlargement:AtrialandVentricularhypertr34AtrialandVentricularhypertrophy

(一）left

VentricularenlargmentQRSvoltage:

①RinV5,6>2.5mV,②RV5+SV1>3.5or4.0mV,③RI>1.5mV,RinaVL>1.2mV,aVF>2.0mV,SinV12.4mV,④RI+SIII2.5mV.leftaxisdeviationQRSduration>0.09ms.STsegmentandTwave

AtrialandVentricularhypertr35left

VentricularenlargmentleftVentricularenlargment36AtrialandVentricularhypertrophy

(二）Right

Ventricularenlargment①V1leadR/S>1,V5leadR/S<1,②Rv1+Sv5>1.05mV.③rightaxisdeviation>+90°.④ST-Tchange

AtrialandVentricularhypertr37Right

VentricularenlargmentRightVentricularenlargment38AtrialandVentricularhypertrophy

(三）BiventricularenlargementApproximatelynormalECG.LeftorRight

VentricularHypertrophyECGBiventricular

HypertrophyECGAtrialandVentricularhypertr39BiventricularenlargementBiventricularenlargement40V. IschemiaandST-TSegmentForms:(1)Ischemia:

a.subendocardialischemiab.subepicardialischemia(2)Injury.

clinicalsignificancedifferentialdiagnosisV. IschemiaandST-TSegmentFo41IschemiaandST-TSegmentIschemiaandST-TSegment42IschemiaandST-TSegmentIschemiaandST-TSegment43IschemiaandST-TSegmentIschemiaandST-TSegment44IschemiaandST-TSegmentIschemiaandST-TSegment45VI.MyocardialInfarction(一）Formsandmechanism1)ischemia2)infury3）infarctionVI.MyocardialInfarction(一）46VI.MyocardialInfarctionVI.MyocardialInfarction47VI.MyocardialInfarctionVI.MyocardialInfarction48VI.MyocardialInfarctionVI.MyocardialInfarction49VI.MyocardialInfarction（二）EvolutionoftheinfarctionanddurationtheECG1)initialphase2)acutephase3)subacutephase4)recoveryphaseVI.MyocardialInfarction（二）50MyocardialInfarctionMyocardialInfarction51VI.MyocardialInfarctionTheECGandlocationofinfarctionVI.MyocardialInfarctionThe52MyocardialInfarctionMyocardialInfarction53MyocardialInfarctionMyocardialInfarction54Nonspesificpatternsofinfarctionnon-QwavemyocardialinfarctioninfarctioncomplicatedwithotherdiseasesdifferentialdiagnosisNonspesificpatternsofinfarc55ECG心電圖的解讀課件56ECG心電圖的解讀課件57ECG心電圖的解讀課件58ECG心電圖的解讀課件59ECG心電圖的解讀課件60ECG心電圖的解讀課件61ECG心電圖的解讀課件62ECG心電圖的解讀課件63ECG心電圖的解讀課件64END16、業(yè)余生活要有意義，不要越軌?！A盛頓

17、一個人即使已登上頂峰，也仍要自強不息?！_素·貝克

18、最大的挑戰(zhàn)和突破在于用人，而用人最大的突破在于信任人?！R云

19、自己活著，就是為了使別人過得更美好。——雷鋒

20、要掌握書，莫被書掌握；要為生而讀，莫為讀而生?！紶栁諩ND16、業(yè)余生活要有意義，不要越軌?！A盛頓65ECG心電圖的解讀ECG心電圖的解讀ECG心電圖的解讀ELECTROCARDIOGRAMECG心電圖的解讀ECG心電圖的解讀ECG心電圖的解讀ELEECG心電圖的解讀課件67ECG心電圖的解讀課件68ECG心電圖的解讀課件69ECG心電圖的解讀課件70插入離子通道圖片插入離子通道圖片71ElectricalbasisandtheoryElectricalbasisandtheory72ElectricalbasisandtheorydepolarizationdipolerepolarizationElectricalbasisandtheorydep73ElectricalbasisandtheoryElectricalbasisandtheory74ElectricalbasisandtheoryqElectricalbasisandtheoryq75Clinical

electrocardiolopyelementaryknowledgeVectorResultantvectorLoopClinicalelectrocardiolopyele76ElectricalbasisandtheoryElectricalbasisandtheory77TheStandard12-leadElectrocardiogramSAnodeBachmannAVnodeHisbundleLeftandrightbranchofbundlePukinjefiberTheStandard12-leadElectroca78TheStandard12-leadElectrocardiogramPWaveP-RintervalQRSComplexSTsegmentTWaveQ-TintervalTheStandard12-leadElectroca79TheStandard12-leadElectrocardiogram

——RWave

formTheStandard12-leadElectroca80LeadSystemoftheECGLimbleads

EinthoventrigoneHexaxialsystemLeadSystemoftheECGLimblea81LeadSystemoftheECGChestleads

LeadSystemoftheECGChestle82ChestleadsChestleads83LeadSystemoftheECGLeadSystemoftheECG84ECG心電圖的解讀課件85ECG心電圖的解讀課件86ECG心電圖的解讀課件87.Ⅱ.ECGEVALUATION

.Ⅱ.ECGEVALUATION88TheStandard12-leadElectrocardiogramHowtomeasureeachwave:amplitudeduration25mm/sTheStandard12-leadElectroca89HowtocalculatetheheartrateHeartRate=60/R-RdurationHowtocalculatetheheartrat90

MeanQRSaxisMeanQRSaxis91CardiacRotationCardiacRotation92.Ⅲ.NORMALECG⒈PWave⒉P-RInterval⒊QRScomplex⒋Jpoint⒌STSegment⒍TWave⒎Q-TInterval⒏UWave.Ⅲ.NORMALECG⒈PWave93.Ⅲ.NOMALECG

——PWave⑴form：I、II、avF、V4-6

⑵duration：<0.12s⑶amplitude:Limbleads

<0.25mV,Chestleads<0.20mV..Ⅲ.NOMALECG

——PWave⑴form：94.Ⅲ.NOMALECG

——P-RIntervalduration：0.12s~0.20s..Ⅲ.NOMALECG

——P-RInterval95.Ⅲ.NOMALECG

——QRScomplex

⑴duration:0.06~0.10s.⑵formandamplitude.⑶Rpeaktime⑷QWave.Ⅲ.NOMALECG

——QRScomplex

96.Ⅲ.NOMALECGJpointSTSegmentTWaveQ-TIntervalUWave.Ⅲ.NOMALECGJpointTWave97IV.TheAbnormalECG

AtrialandVentricularhypertrophyIV.TheAbnormalECGAtria98AtrialandVentricularhypertrophy

(一）atrialenlargmentLeftatrialenlargementRightatrialenlargement:AtrialandVentricularhypertr99AtrialandVentricularhypertrophy

(一）left

VentricularenlargmentQRSvoltage:

①RinV5,6>2.5mV,②RV5+SV1>3.5or4.0mV,③RI>1.5mV,RinaVL>1.2mV,aVF>2.0mV,SinV12.4mV,④RI+SIII2.5mV.leftaxisdeviationQRSduration>0.09ms.STsegmentandTwave

AtrialandVentricularhypertr100left

VentricularenlargmentleftVentricularenlargment101AtrialandVentricularhypertrophy

(二）Right

Ventricularenlargment①V1leadR/S>1,V5leadR/S<1,②Rv1+Sv5>1.05mV.③rightaxisdeviation>+90°.④ST-Tchange

AtrialandVentricularhypertr102Right

VentricularenlargmentRightVentricularenlargment103AtrialandVentricularhypertrophy

(三）BiventricularenlargementApproximatelynormalECG.LeftorRight

VentricularHypertrophyECGBiventricular

HypertrophyECGAtrialandVentricularhypertr104BiventricularenlargementBiventricularenlargement105V. IschemiaandST-TSegmentForms:(1)Ischemia:

a.subendocardialischemiab.subepicardialischemia(2)Injury.

clinicalsignificancedifferentialdiagnosisV. IschemiaandST-TSegmentFo106IschemiaandST-TSegmentIschemiaandST-TSegment107IschemiaandST-TSegmentIschemiaandST-TSegment108IschemiaandST-TSegmentIschemiaandST-TSegment109IschemiaandST-TSegmentIschemiaandST-TSegment110VI.MyocardialInfarction(一）Formsandmechanism1)ischemia2)infury3）infarctionVI.MyocardialInfarction(一）111VI.MyocardialInfarctionVI.MyocardialInfarction112VI.MyocardialInfarctionVI.MyocardialInfarctio