A Electrocardiographic Study of Normal Newborn Infants

正常新生兒心電圖之研究

呂鴻基(Hung-Chi Lue) ； 陳烱明(Chiung-Min Chen) ； 陳烱霖(Chiung-Lin Chen)

《Acta Paediatrica Sinica》 3卷4期 (1962/12) Pp. 129-142

摘要

嬰兒出生，隨著呼吸的開始，循環系統卽由胎兒型演變爲嬰兒型者。許多的生理現象，諸如肺動脈血壓的降低，左心房血量及血壓的增高，卵圓孔瓣膜掩閉的開始，及動脈管血流的改向或停止等，卽相繼發生。此循環系統演變期間的心電圖變化之研究，雖極爲有趣而有用，但在我國文獻上未有所見。
著者等使用Sanborn　Twin-beam Model 62，照相式心電描記器，就63例正常新生兒錄取心電圖。其中30例爲出生後24小時以內，而另33例爲出生後24小時至一週以內者。所使用的心電圖誘導爲三個標準肢誘導，三個單極肢誘導及八個單極心前誘導（包括V4R，V3R，Vl~6）。
本研究的目的有二，l)研究在此循環系統演變期間的心電圖特徵。2)建立我國新生兒出生至一週期間的正常心電圖規準。
出生一週以內心電圖的特徵為：l)在肢誘導出現右偏電軸(Right axis deviaton).2)尖形P波(Peaked P wave)為常見者。3)Q波常見於Ⅱ,Ⅲ，aVF及aVR誘導，在臨床上的意義極少。4)右側心前部誘導上的R波特高。5)右側心前部誘導的T波，出生直後為陽性而堅型者(Positive and upright)，但自生後24至48小時開始倒反，於數天內完全演變為倒反(Inverted)。左側心前部誘導的T波，在同一個時期中，由倒反或低陽性者漸變為高陽性。6)出生一天以內的Q-T時間稍長於其他期間者。
心電圖諸要素的平均，最小及最大長度，高度及電軸角度等，列如表I-XXⅢ及圖1~5。最後對於嬰孩心電圖有關的最近文獻亦有論及。

並列摘要

At birth a fundamental change in the circulation occurs. With the establishment of respiration the lungs expand, the pulmonary pressure falls, the blood in the left auricle increases, the pressure in the left auricle rises and the valve covering the foramen ovale tends to close, and the direction of the blood flow through the ductus arteriosus is reversed or virtually ceases1. Thus, in stead of one circulation-systemic, two circulations-systemic and pulmonary-are established. All these changes are reflected more or less in the electrocardiograms.
It was in 1908, five years after Einthoven's invention of the string galvanometer, when Nicolai and Funaro published the first study of electrocardiograms in infants and children^2. The studies made hither-to-now disclose that the patterns of electrocardiogram vary progressively with age as with growth of the. infants and chi1dren.^3,4,5,6,7,8 Establishment of adequate standards of the normal, therefore, should be of fundamental importance before any attempt is made for diagnostic evaluation of the abnormal.
Because there, was no such a study ever made in Taiwan, our purpose in undertaking this work is to find out the characteristic electrocardiographic patterns during the period of from birth to one week of life, and to establish criteria for the electrocardiograms of normal newborn in this particular period of life.