肺癌并发心律失常临床特点及支气管镜检查安全性分析

Clinical characteristics and safety analysis of bronchoscopy in lung cancer patients with arrhythmia

目的 分析肺癌并发心律失常的临床特征,探讨对此类患者行支气管镜检查的安全性。方法 选择2021年3月至2022年6月我院收治的经支气管镜检查确诊肺癌患者65例,将肺癌并发心律失常33例为观察组,肺癌无心律失常32例为对照组,比较两组患者的临床特征,分析并发心律失常对支气管镜检查安全性的影响。结果 观察组窦性心动过速18例,房性早搏13例,室性早搏10例,心房颤动6例,室上性心动过速1例,右束支传导阻滞4例。观察组患者中央型病变[19例(57.6%)vs. 10例(31.3%)]、临床分期Ⅲ和Ⅳ比例[31例(93.9%)vs. 23例(71.9%)]高于对照组(P<0.05)。患者行支气管镜诊疗过程中,心律失常为9例(13.8%),观察组发生6例(18.2%),对照组发生3例(9.4%),两组差异无统计学意义。中止支气管镜操作、撤出气管镜后,心律恢复至术前水平。两组患者低氧血症、气胸、出血的发生率比较,差异无统计学意义。结论 中央型肺癌和Ⅲ、Ⅳ期肺癌患者易合并心律失常;经药物控制后,在镇静状态下行支气管镜诊疗具有良好安全性。

Objective To analyze the clinical characteristics and explore the safety of bronchoscopy in lung cancer patients with arrhythmia.Methods A retrospective analysis was performed in 65 lung cancer patients with arrhythmia in our hospital from March 2021 to June 2022.They were divided into lung cancer with arrhythmia group(observation group,33 cases)and lung cancer without arrhythmia group(control group,32 cases).The clinical characteristics of the two groups were comparable.Results Among the 33 patients in the observation group,18 had sinus tachycardia,13 had atrial premature beats,10 had ventricular premature beats,6 had atrial fibrillation,1 had supraventricular tachycardia,and 4 had right bundle branch block.Compared with the control group,patients in the observation group had more central type lesions[19 cases(57.6%)vs.10 cases(31.3%)]and later clinical stages[31 cases(93.9%)vs.23 cases(71.9%)](P<0.05).The incidence of arrhythmia was 9 cases(13.8%)in the 65 patients undergoing bronchoscopy,6 cases(18.2%)in the observation group,and 3 cases(9.4%)in the control group.There was no statistical difference between the two groups.Arrhythmia could be recovered to the preoperative level after the bronchoscope was withdrawn.There was no significant difference in the incidence of hypoxemia,pneumothorax,and bleeding between the two groups.Conclusion Lung cancer patients with central type lesions or stageⅢ/Ⅳare more likely to have arrhythmia.After arrhythmia was controlled by drug,bronchoscopy under sedation has satisfactory safety.