Casteel H B, Fiedorek S C, Kiel E A
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Gastrointest Endosc. 1990 Sep-Oct;36(5):489-93. doi: 10.1016/s0016-5107(90)71122-4.
Arterial blood oxygen desaturation and abnormal electrocardiographic changes have been reported in adults undergoing upper gastrointestinal endoscopy. We studied 32 infants and children less than 12 years of age using pulse oximetry and continuous electrocardiography before, during, and after upper gastrointestinal endoscopy performed under intravenous sedation. Sinus tachycardia was the most common electrocardiographic change, and no clinically significant electrocardiographic abnormalities were induced by the procedure. Desaturation to less than or equal to 90% was found in 37.5% of the patients and was most commonly noted during the endoscopy procedure and in patients with cardiopulmonary disease. The desaturation was unpredictable because there was no correlation between desaturation and medication, tolerance to the procedure, weight, or age of the child. Some patients who subjectively appeared to tolerate the procedure well had significant desaturation. The use of pulse oximetry should be considered for all children undergoing upper gastrointestinal endoscopy.
据报道，接受上消化道内镜检查的成人会出现动脉血氧饱和度下降和心电图异常变化。我们对32名12岁以下的婴幼儿进行了研究，在静脉镇静下进行上消化道内镜检查的前、中、后阶段，使用脉搏血氧饱和度仪和连续心电图监测。窦性心动过速是最常见的心电图变化，该检查未诱发具有临床意义的心电图异常。37.5%的患者血氧饱和度降至90%及以下，最常见于内镜检查过程中以及患有心肺疾病的患者。血氧饱和度下降无法预测，因为其与所用药物、对检查的耐受性、体重或患儿年龄之间并无关联。一些主观上似乎对检查耐受良好的患者却出现了明显的血氧饱和度下降。对于所有接受上消化道内镜检查的儿童，均应考虑使用脉搏血氧饱和度仪。
