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目的:探讨高原施工中高海拔跨度运输作业对司乘人员红血球压积与心电图变化的影响及相关性。方法:利用SPSS11.0版统计软件对2003年参加青藏铁路建设司乘人员工前、工中、工后体检资料中的红血球压积和心电图进行统计分析,并与同时间段在固定海拔的施工者进行比较。结果:在一个施工年内高海拔跨度作业司乘人员红血球压积缓慢持续升高至工后达最高水平(P<0.01),而此时心电图异常率则显著下降(P<0.05);红血球压积在45.12%~52.24%之间,达到52%时心电图异常率得到显著改善,并且相关分析在此红血球压积范围心电图改变与红血球压积密切负相关(P<0.05)。结论:高海拔跨度作业司乘人员虽然长期对环境处于较高水平的应激状态而使血液红血球压积持续升高,但最终达到较合理红血球压积代偿使之处于“Hct最适宜”状态,从而改善了组织、器官的灌流状态,使心肌组织氧供达到最佳代偿从而使心电图异常率得到了显著改善。
Objective: To investigate the influence and correlation of red blood cell hematocele and electrocardiogram (ECG) changes of passengers and passengers on high altitude during the plateau construction. Methods: Statistical analysis of hematocrit and electrocardiogram in physical examination data of passengers taking part in the Qinghai-Tibet Railway Construction Department in 2003 before and after taking part in the physical examination by means of statistical software SPSS11.0 was conducted in 2003, and compared with the same period in the fixed altitude construction For comparison. Results: During the year of construction, the occupational hematocrit of patients at high altitudinal span increased slowly and reached the highest post-operative level (P <0.01), while the abnormal rate of electrocardiogram decreased significantly (P <0.05) Between 45.12% and 52.24%, the abnormal rate of electrocardiogram was significantly improved when it reached 52%. Correlation analysis showed that the changes of electrocardiogram in the range of hematocrit were negatively correlated with the hematocrit (P <0.05). CONCLUSIONS: Although high-altitude spans crew members continue to increase the hematocrit of the blood for a long period of time when the environment is at a high level of stress, the more reasonable hematocrit compensation finally achieves the “optimal Hct” state , So as to improve the tissue and organ perfusion state, make the myocardial tissue oxygen supply to achieve the best compensation so that the ECG abnormality rate has been significantly improved.