Kaga K, Nemoto E, Fukai S, Yanai N, Inoue H
Department of Surgery, Tokai University School of Medicine, Isehara, Japan.
Kyobu Geka. 1999 Feb;52(2):115-9.
118 patients with lung cancer who underwent treadmill exercise electrography (ECG) as part of their preoperative evaluation, were investigated for postoperative events. On the treadmill exercise ECG 27 patients were positive and 91 were negative. The more elderly patients tended to reveal ischemic findings in treadmill exercise ECG. Of the 71 patients with normal of result by ECG at rest, 15 patients (21.1%) had postoperative ischemic change on ECG. As a result, it was considered that this examination was insufficient to detect latent ischemic heart disease. The patients who had a discontinued at stage 2 or less of the Bruce protocol and had a negative result by treadmill exercise ECG, were classified as insufficient group and separated from the others. (27/118 patients). This group consisted of advanced age (p < 0.05) who tended to experience postoperative events. In the sufficient group, patients showed ischemic events predominantly on ECG at postoperative period (p < 0.01). We concluded that as preoperative screening of heart disease prior to lung cancer surgery ECG at rest was not adequate while treadmill exercise ECG was useful.
118例接受平板运动心电图(ECG)检查作为术前评估一部分的肺癌患者,接受了术后事件调查。在平板运动心电图检查中,27例患者结果呈阳性,91例呈阴性。年龄较大的患者在平板运动心电图中更易出现缺血表现。在静息心电图结果正常的71例患者中,15例(21.1%)术后心电图出现缺血性改变。因此,认为该项检查不足以检测出潜在的缺血性心脏病。在布鲁斯方案2级及以下阶段运动终止且平板运动心电图结果为阴性的患者被归为不足组,并与其他患者分开(27/118例患者)。该组患者年龄较大(p<0.05),术后更易发生事件。在充足组中,患者术后主要在心电图上出现缺血事件(p<0.01)。我们得出结论,作为肺癌手术前心脏病的术前筛查,静息心电图不够充分,而平板运动心电图则很有用。