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喉肌电图检查过程中的血流动力学稳定性。

Hemodynamic stability during laryngeal electromyography procedures.

作者信息

Lu Yi-An, Pei Yu-Cheng, Wong Alice Mk, Chiang Hui-Chen, Fang Tuan-Jen

机构信息

a Department of Otolaryngology , Chang Gung Memorial Hospital at Linkou , Taoyuan , Taiwan.

b School of Medicine , Chang Gung University , Taoyuan , Taiwan.

出版信息

Acta Otolaryngol. 2017 Oct;137(10):1110-1114. doi: 10.1080/00016489.2017.1334961. Epub 2017 Jun 23.

Abstract

BACKGROUND

Laryngeal electromyography (LEMG) is accepted as safe, with minimal side effects. However, patient hemodynamic stability, during these procedures, has not been reported. This study aimed to investigate the hemodynamics in patients undergoing LEMG and determine the risk factors for hemodynamic changes.

METHODS

We recruited 89 consecutive patients who underwent LEMG. Baseline and postprocedural changes in vital signs were analyzed.

RESULTS

Diastolic blood pressure (DBP) increased from 75.08 ± 11.54 mmHg preprocedure to 77.4 ± 11.91 mmHg postprocedure (p = .006); pulse rate (PR) increased from 78.1 ± 13.3 beats per minute preprocedure to 80.02 ± 13.69 postprocedure (p = .027). Systolic blood pressure (SBP) and oxygen saturation were unchanged after the procedure. However, about 17% of patients experienced profound changes in vital signs of >20% above baseline during LEMG. The hemodynamic changes did not differ between sexes or between surgical and non-surgical etiologies of vocal fold paralysis. Two patients experienced profound but reversible near-syncope during the procedure.

CONCLUSIONS

LEMG is a safe procedure with few immediate complications, though it may affect the patient's hemodynamic status by increasing DBP and PR. The hemodynamic monitoring is recommended so that timely intervention can be applied in case any warning sign occurs.

摘要

背景

喉肌电图检查(LEMG)被认为是安全的,副作用极小。然而,在此类检查过程中患者的血流动力学稳定性尚未见报道。本研究旨在调查接受喉肌电图检查患者的血流动力学情况,并确定血流动力学变化的危险因素。

方法

我们连续招募了89例接受喉肌电图检查的患者。分析了术前和术后生命体征的变化。

结果

舒张压(DBP)从术前的75.08±11.54mmHg升至术后的77.4±11.91mmHg(p = 0.006);心率(PR)从术前的每分钟78.1±13.3次升至术后的80.02±13.69次(p = 0.027)。术后收缩压(SBP)和血氧饱和度无变化。然而,约17%的患者在喉肌电图检查期间生命体征出现超过基线20%的显著变化。血流动力学变化在性别之间或声带麻痹的手术和非手术病因之间无差异。两名患者在检查过程中出现严重但可逆的接近晕厥情况。

结论

喉肌电图检查是一种安全的检查方法,即刻并发症较少,尽管它可能通过升高舒张压和心率影响患者的血流动力学状态。建议进行血流动力学监测,以便在出现任何警示信号时能及时进行干预。

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