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頁籤選單縮合
題名 | A Retrospective Study of Myocardial Damage in Electrical Burn Injuries=電燒傷對心臟損害之研究 |
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作者 | 劉永森; 葉發來; 吳肇毅; 黃志宏; 馬旭; 林進德; 方榮煌; | 書刊名 | 中華民國重建整形外科醫學會雜誌 |
卷期 | 6:4 1997.12[民86.12] |
頁次 | 頁233-237 |
分類號 | 416.141 |
關鍵詞 | 電燒傷; 心臟損害; Myocardial damage; Electrical burn injury; |
語文 | 英文(English) |
中文摘要 | 電燒傷可能造成心臟損害包括心律不整或心肌損傷,臺北榮總從1994年一月到1996 年十二月共收集42位因電燒傷住燒傷中心的病患資料。從病患到急診室開始定期以十二導 程心電圖,二十四小時心電圖監測及測血中肌氨酸酵素濃度的方式來研究心臟受損害程度。 病人平均年齡33.1歲。其中有33位是受高壓電(大於1000伏特)電傷。病患中有19位 曾有不同時間長短的失去意識,都沒有發現心臟休克現象。在急診室發現有9位心電圖異常, 大多是沒有特殊意義的異常。住在燒傷中心只有2位產生心律不整,但都在一二天內恢復正 常。其中有35位病人的最大血中肌氨酸酵素濃度有昇高。我們整個治療或手術期間都沒有 心臟受損衰竭的現象產生。結論是在電燒傷患者中,遲發性的心臟異常包括心律不整及衰竭, 是很少見的。而且電燒傷他會造成血中肌氨酸酵素濃度異常升高,並不表示心肌損傷。 |
英文摘要 | Cardiac abnormalities, such as arrhythmia and myocardial injuries, were always considered a sequence of syndrome happened in electrical injury patients. In VGH-Taipei, from Jan 1994 to Dec 1996, forty-two patients with non-arc type electrical injury admitted to burn unit were recruited. Serial 12-ECF, 24-hour Holter monitoring and serum CK and CK-MB were used to evaluate the incidence of myocardial damage as soon as patient's arrival at emergency room. The average age was 33.1 years old (range from 10 to 59 years old). There were 33 high-voltage (>1000 volts) injuries and 9 low voltage injuries. Nineteen of the 42 patients suffered from conscious loss for some time on the scene of electrical injury, no cardiac arrest was found. Abnormal ECG findings were noted in 9 patients but mostly nonspecific. Only 2 patients showed arrhythmias (atrial fibrillation and occasional VPCs) during admission in burn unit, which returned to normal sinus rhythim within one to two days without specific treatment. Maximal CK values were elevated in 35 patients and increased maximal CK-MB to CK ratio in 23 patients of them. None of the 42 patients demonstrated evidence of impaired heart function. According to our series of patients, delayed cardiac events, such as arrhythmia and myocardial damage, were rare in electrical injuries; and elevation of CK-MB alone is not a reliable criteria for injury of heart. |
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