食管癌三维适形放疗致心电图异常临床研究.docVIP

食管癌三维适形放疗致心电图异常临床研究 　　 [摘要] 目的 通过对三维放射治疗的食管癌患者进行常规心电图检测，分析受照射心脏的早期心电图改变。方法选取2010年1月~2012年1月收治的58例食管癌患者，进行三维适形放疗并在放疗前、放疗中和放疗结束时分别作心电图检测。胸中下段37例 ，胸上段21例。放疗剂量≤55 Gy组25例、55 Gy组33例。 结果 放疗后，心电图异常发生率为51.7%，明显高于放疗前（P＜0.01），其中窦性心动过速占29.3%，窦性心动过缓占6.9%，ST-T段改变占8.6%，传导阻滞占6.9%；胸中下段食癌的心电图异常率明显高于胸上段食管癌（P55 Gy组高于≤55 Gy组（P0.01）。 结论 放射治疗可导致心电图异常变化，其异常率与心脏受照射体积、放疗剂量有关。 　　[关键词] 食管癌；三维适形放疗；心电图异常 　　[中图分类号] R735.1[文献标识码] A[文章编号] 1674-4721（2014）05（b）-0036-03 　　 　　A clinical study of abnormal electrocardiogram caused by three dimensional conformal radiotherapy for esophageal carcinoma 　　XU Fu-jin１ BU Xiang-zhao2▲ ZHANG Kun１ WANG Kun１ 　　1.Department of Oncology Radiotherapy,People′s Hospital of Dangshan County in Suzhou City of Anhui Province,Dangshan 235300,China;2.Department of Radiotherapy,Xuzhou Center Hospital Affiliated to Southeast University,Xuzhou 221009,China 　　[Abstract] Objective To analyze the early stage changes in electrocardiogram (ECG) of the heart injury-induced by three?dimensional conformal radiotherapy (3D-CRT) for the esophageal carcinoma. Methods 58 patients with esophageal carcinoma from January 2010 to January 2012 were treated and selected,and patients were conducted 3D-CRT,and were given ECG examination at the beginning,midway,and the end of the radiotherapy.Among them, there were 37 cases of middle-lower thoracic segment,and 21 cases belong to up thoracic segment.The radiotherapy dose were less than or equal to 55 Gy in 25 cases,above 55 Gy in 33 cases. Results After radiotherapy,the total incidence rate of abnormal ECG (51.7%) was higher than that pre-radiotherapy (P＜0.01),in these,sinus tachycardia accounted for 29.3%,sinus bradycardia accounted for 6.9%,ST-T segment change accounted for 8.6%,conduct block conduct block 6.9%;the incidence rate of abnormal ECG in patients with middle-lower thoracic segment was higher than that in up thoracic segment (P0.05);and it was also higher in the patients with radiotherapy dose more than 55Gy compared with in thos