结肠镜检查过程中冠心病患者的动态心电图变化分析

The electrocardiogram analysis of electronic coionoscopy on patients with coronary artery heart disease

目的通过动态心电图观察在电子结肠镜检查过程中冠心病患者心电图的变化，评估冠心病患者行结肠镜检查的安全性。方法选择2012年6月至2013年6月行结肠镜检查的患者60例，确诊冠心病患者30例为试验组，另30例为对照组。通过动态心电图比较两组患者电子结肠镜检查前、检查中心电图的变化情况。结果两组患者在结肠镜检查前心率差异无统计学意义（t=0．537，P〉0．05）。检查过程中均有不同程度的心率增快，但试验组增：陕程度[（73．20±7．91）次／min增加到（88．67±7．79）次／min]，相对于对照组[（73．40±6．44）次／min增加到（74．88±7．82）次／min]更加明显，两组比较差异有统计学意义（t=4．462，P〈0．05）。结肠镜检查中试验组、对照组心律失常发生率分别为46．67％（14／30）、20．00％（6／30），差异有统计学意义（X2=4．8，P〈0．05）；结肠镜检查过程中试验组、对照组ST—T改变发生率分别为26．7％（8／30）、10．0％（3／30）（X2=45．72，P〈0．05）；两组患者在结肠镜检查过程中均有出现主观不适，两组发生率分别为40％、30％，（x2=0．659，P〉0．05）。结论冠心病患者较无冠心病患者在结肠镜检查过程中更易出现心率加快、心律失常、ST—T改变，但未见严重心电学改变冠心病患者行结肠镜检查相对安全。

Objective To investigate the electrocardiogram analysis of electronic colonoscopy on patients with coronary artery heart disease, and to evaluate the safety of colonoscopy on patients with coronary artery heart disease. Methods Sixty patients who underwent colonoscopy from Jun. 2012 to Jun. 2013 were divided into experimental group （ patients with coronary artery heart disease, Heart function class I -III ） and control group （patients without coronary artery heart disease ）. The changes of electrocardiography during colonoscopy and before performance were compared between two groups through dynamic electrocardiogram. Results Heart rate of the two groups were no statistically significant difference before colonoscopy process （ t = 0. 537, P 〉 0. 05 ）. During the inspection process, there was heart rate increase at different degree in two groups. The heart rate in patients of experiments group was increased from （ 73.20 ± 7.91 ） times/min to （ 88.67 ± 7.79 ） times/rain, which waas more than that in control group （ from （73.40 ± 6.44） times/min to （74. 88 ± 7. 82）times/min）, and the difference between the two groups was significant（ t = 4. 462,P 〈 0. 05 ）. During colonoscopy inspection, the arrhythmia rate arrhythmia in experiment and control group were 46. 67% （ 14/30）, 20. 00% （ 6/30 ）, and the difference was statistically significant （ x2 = 4. 8, P 〈0. 05）. Meanwhile, ST-T change rates in experimental group and control group were 26.7% （8/30） and I0.0% （3/30）（x2 =45.72,P 〈0.05）. The rate of subjective discomfort the two groups were 40% ,30% （x2