无痛胃镜及普通胃镜检查心律失常发生率的比较

目的:对比观察无痛胃镜及普通胃镜检查心律失常发生率,探讨无痛胃镜检查的心血管安全性。方法:将300例接受胃镜检查患者随机分成无痛胃镜检查组(A组)和普通胃镜检查组(B组)(n=150),术前、术中、术后进行心电图(EKG)监测。结果:在胃镜操作前,两组心电图无差异。胃镜操作时心率增快者A组为3.3%,B组为80.6%,两组比较有显著性差异(P<0.05);窦缓A组为3.3%,B组为0%,两组比较无显著性差异(P>0.05);室性早搏A组为0.7%,B组为5.3%,两组比较有显著性差异(P<0.05);ST-T改变A组为1.3%,B组为8.0%,两组比较有显著性差异(P<0.05);室上性早搏A组为1.3%,B组为6.7%,两组比较有显著性差异(P<0.05),术后均很快恢复到术前状态。结论:无痛胃镜检查在心血管安全性方面优于普通胃镜检查,术前有EKG异常改变者建议在麻醉医师的监护下进行无痛胃镜检查。

Comparison of arrhythmia in conventional gastroscopy and analgesic gastroscopy

Objective: To investigate the incidence of arrhythmia in conventional gastroscopy and analgesic gastroscopy and evaluate the cardiovascular safety of analgesic gastroscopy.Methods: Three hundred patients undergoing gastroscopy were randomly divided into group A(n=150) and group B(n=150);patients in group A underwent analgesic gastroscopy,patients in group B underwent conventional gastroscopy.Eletrocardiography(EKG) was employed for the patients before,during and after the gastroscopy.Results: There was no significant difference in EKG between two groups before gastroscopy.During the procedure of gastroscopy,percentiles of quickened heart rate in group A and group B were 3.3% and 80.6% respectively,ventricular premature beat(group A 0.7%,group B 5.3%),ST-T change(group A 1.3%,group B 8.0%),artrial premature beat and artrioventricular junctional premature beat(group A 1.3%,group B 6.7%),compared them respectively,there were significant differences(all P<0.05).There was no significant difference in sinus bradycardia(group A 3.3%,group B 0).The EKG changes during gastroscopy disappeared quickly after gastroscopy.Conclusion: Analgesic gastroscopy is safer in heart than conventional gastroscopy;patients with abnormal EKG undergoing analgesic gastroscopy are better to be monitored by anaesthetist.