无痛胃镜及普通胃镜检查心律失常发生率的比较.docVIP

无痛胃镜及普通胃镜检查心律失常发生率的比较　　作者：王家顺 作者单位：上海市东方医院集团宿迁分院消化内科，江苏 宿迁 223800 　　【摘要】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(P0.05);窦缓A组为3.3%，B组为0%，两组比较无显著性差异(P0.05); 室性早搏A组为0.7%，B组为5.3%，两组比较有显著性差异(P0.05);ST改变A组为1.3%，B组为8.0%，两组比较有显著性差异(P0.05);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(P0.05)，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。 　　【关键词】 胃镜检查 镇痛 心律失常 心电描记术 　　Comparison of arrhythmia in conventional gastroscopy and analgesic gastroscopy 　　WANG Jia 　　(Department of Gastroenterology, Suqian Hospital of Shanghai Oriental Hospital Group Suqian 223800,China) 　　[ABSTRACT] 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 P0.05). 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 gastros