Dombret M C, Juliard J M, Farinotti R
Unité de Pneumologie, Hôpital Bichat, Paris.
Rev Mal Respir. 1990;7(4):313-7.
In order to study the electrical changes that may occur during bronchoscopy in coronary patients we have carried out continuous electrocardiographic recordings during the course of endoscopy in 36 patients. We have been able to compare two groups: Group 1 consisting of 18 patients with coronary disease, and Group 2 with 18 non-coronary patients. There was no difference for sex, age or blood gases at the time of the examination in either group. Continuous electrocardiographic recording was started one hour before the examination and went on until two hours after, and was analysed as a function of the different durations of the endoscopy and any possible incidents. The blood potassium and the lidocaine blood levels at the end of the examination did not differ between the two groups. We observed no disorders of rhythm or of conduction. The only common change in the two groups was a frequent elevation of heart rate. There was no difference between the two groups. We have on the other hand been able to show in 3 coronary patients problems of repolarisation, which looked like current ischaemia occurring during the bronchoscopy and disappearing after the examination. We had no clinical upsets and do not have to regret having done any of the examinations, but these observations suggest we should be particularly careful in considering the indications for bronchoscopy, and the surveillance of patients during bronchoscopy where there is coronary disease.
为了研究冠心病患者在支气管镜检查过程中可能发生的电变化,我们对36例患者在内镜检查过程中进行了连续心电图记录。我们能够比较两组:第1组由18例冠心病患者组成,第2组由18例非冠心病患者组成。两组在检查时的性别、年龄或血气方面均无差异。连续心电图记录在检查前1小时开始,持续到检查后2小时,并根据内镜检查的不同持续时间和任何可能的事件进行分析。两组在检查结束时的血钾和利多卡因血药浓度没有差异。我们没有观察到节律或传导障碍。两组唯一常见的变化是心率频繁升高。两组之间没有差异。另一方面,我们在3例冠心病患者中发现了复极问题,表现为支气管镜检查期间出现的类似当前缺血的情况,检查后消失。我们没有临床不适,也不后悔进行了任何一项检查,但这些观察结果表明,在考虑支气管镜检查的适应症以及对冠心病患者进行支气管镜检查期间的监测时,我们应该格外小心。