推荐回答(3个)
格子虽小,但凭肉眼多已能作出判断。
在纸速为25mm/秒时,横向1小格为0.04秒;标准电压为10mm/1mv时,纵向1小格为0.1mv。(临床上还会在电压高时,用半电压[1/2 电压],此时纵向1小格则为0.2mv)
由于心电图正常值多定为与小格相关的数值,故在许多情况下并不需要看得非常清楚,只需确定在某个范围之内即可(何况那些所谓的正常值是人为根据统计学的结果确定的)。
常用正常值如:
1. 时间:横向测量。正常纸速时:
▲PR间期0.12~0.20秒 → 3~5个小格;
▲QT间期0.32~0.44秒 → 8~11个小格;
▲P波时间为<0.12秒 → <3个小格;
▲QRS间期0.06~0.10秒 → 1个半~2个半小格;
▲Q波时间<0.04秒 → <1个小格;……
2. 电压:纵向测量。标准电压的情况下:
▲P波电压:(1)肢体导联<0.25mV → <2个半小格;(2)胸导联<0.20mV → <2个小格;
▲R波电压:(1)aVR导联<0.5mV → <5个小格;(2)aVL导联<1.2mV → <12个小格;……
▲Q波电压≤同导联1/4的R波 → 先测量R波电压即可
▲ST段电压≤0.5mV → ≤半个小格;……
显然经过一定时间的训练,完全可以肉眼判断各项值是否正常。
如果要在心电图报告纸上写出精确值,为追求非常精确,须用圆规测量。值取2位数即可。
在极特殊情况下,可重做一份纸速快、电压高的心电图专用作测量出各项值(方法:选纸速为50mm/秒时,此时横向1小格为0.02秒;标准电压为20mm/1mv时,此时纵向1小格为0.05mv)。但似乎没人真的这样做。因纸速快会浪费心电图纸,电压高有可能损坏描记笔。
我想如果你在临床上看到的典型心电图你就能知道怎么看了,看到的是典型一打眼就知道是不是正常范围,否则仔细看得看到什么时候去啊,ST改变 不典型的 是不怎么好看,得仔细看!呵呵!
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