纤维支气管镜检查中动态心电图的监测评价

Observation and evaluation for the fiber bronchuscopy by HOLTER

目的为探讨纤维支气管镜检查对心血管系统的影响,更好地掌握冠心病患者的纤维支气管镜检查适应情况。方法在纤维支气管镜检查全程中使用Holter监测,包括术前、麻醉、活检、刷检、术后等各个环节,进行心电动态监护记录并立即回放分析,分析各个操作环节的心电变化。结果在对照和观察两组208例检查中全部发生心动过速心律失常(分别为15.0%和18.5%)、ST-T变化(分别为26.0%和27.7%)等异常现象。但两组差异没有非常显著性意义(P>0.05)。结论当通气功能受到影响并伴有黏膜表面麻醉以及支气管系统受到刺激后,对病人的心血管系统造成一定的影响,但一般不会引起严重的心血管系统并发症,通过DCG监测分析为进行纤维支气管镜检查的操作者提供具有一定参考意义的适应证标准。

Objective: To research effect of system of heart and vessel in the fiber bronchuscopy (FFB), to master suitability of patient with dynamic electrocardiogram in FFB further. Methods: To use HOLTER to observe all procedure of FFB, include before operation, anaesthesia, cells brushing, biopsy. To record change of heart electric gram all procedure of FFB and analysis the result of Holter at once. Results: Comparison and observation two groups of cases with tachycardia and acceleration, the rhythm of the heart was 15% and 18.5% separately, the changes of ST-T was 26% and 27.7% separately. But there was no obvious differrence (P >0.05) between two groups of cases. Conclusion: When the negative effect for function of aerates of bronchus and bronchus membrance anaesthesia and dash for bronchus system, there is negative effect for heart and blood vessel system, but there is no serious complication in the heart and blood vessel system. It is value that DCG observe and analysis provide useful standard of indication for FFB operater.