老年人纤维支气管镜检查时血气与心电图的监测

ARTERIAL BLOOD GAS AND ELECTROCARDIOGRAM MONITOR DURING FIBROPT1C BRONCHOSCOPY IN THE AGED

本文对110例纤支镜检查时作血气及心电田监测,以年龄60岁以上,50～59岁及40岁以下分为3组。PaO_2在检查前3组分别为11.82±1.11kPa,11.99±1.16kPa及12.45±1.24kPa。检查时及检查后PaO_2在3组中均有下降,但下降程度3组无明显差异。心电图改变在50岁以上两组中较为多见。心律失常各组在检查时均有发生,但在检查时虽PaO_2进一步下降,但大都均消失,其发生与PaO_2的水平无关。可能系支气管内刺激所致。心电图其他改变如ST-T改变,Q-T延长可随PaO_2的下降而出现,检查后仍持续存在。这些改变是与PaO_2的下降有关。因此我们认为纤支镜检查对老年人也是一种安全的检查方法;但如同时有冠心后或慢阻肺后以及PaO_2在9.31kPa以下者应予以吸氧和心电图监护以策安全。

The purpose of this study is to investigate the changes of blood gas and ECG during fibroptic bronchoscopy in 110 patients suspected of having lung cancer or hemoptysis with unknown origin. Among them are 38 patients at the age of 60 or more as proup A; another 38 aged 50-59 as group B, and the remaining under 50 as group C. PaO2 before the procedure were 11.82±1.11 kPa, 11.99±1.16 kPa and 12.45±1.24 kPa respectively but declined during and after the procedure in all the groups. However, no significant decrease ( P>0.05) after the procedure was observed. ECG abnormalities occurred more frequently in group A and B than in group C. Arrhythmias was found in association with PaO2 decre sing during the procedure in all the groups, but disappeared after the procedure with PaO2 decreasingfurther in the majority of them. There was no correlation between the arrhythmias present and the PaO2 level. It is believed that the arrhythmias probably are attributed to irritation in the bronchi during the procedure. Other ECG abnormalities, stch as ST-T change and Q-T prolongation, are present with PaO2 decreasing during the procedure and still exist after the procedure, which may be related to PaO2 declining. So we presume that the fibroptio bronchoscopy is a safe diagnostic procedure in the aged. But in those aged patients, especially with preexisting coronary heart disease and chroaic obstructive pulmonary disease and those with PaO2 less than 9.31 kPa, the oxygen inhalation and ECG monitor is indicated for safety.