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食管-胃-十二指肠镜检查期间心血管参数和血浆游离脂肪酸的检测(作者译)

[Examination of cardiovascular parameters and plasma free fatty acids during esophago-gastro-duodenoscopy (author's transl)].

作者信息

Pristautz H, Biffl H, Pinl F

出版信息

Z Gastroenterol. 1978 Aug;16(8):490-6.

PMID:685345
Abstract

53 patients were examined for changes of blood pressure, heart rate, ECG and plasma free fatty acids during esophago-gastro-duodenoscopy. In 23 cases there were premature contractions, occuring in small numbers only in most of the cases. Only in 5 cases there was an accumulation of premature contractions and in one case ventricular bigeminism occurred. The maximum of premature beats was observed when the primarily sitting patient was put into supine position. In 7 patients there was a lowering of the ST-segment in the ECG by at least 0.1 mV, mostly in patients who already had an abnormal ST-segment before endoscopy. The pulse rate went up by an average of 50.1 per cent, the systolic blood pressure by 14 and the diastolic blood pressure by 17 per cent. The increase of plasma free fatty acids in the total patient material was not statistically significant, but patients with a deterioration of ECG-findings endoscopy had a significantly higher increase of plasma free fatty acids. There was a tendency towards a positive correlation between the number of premature beats and the increase of plasma free fatty acids. It cannot be decided from our study whether the mobilization of free fatty acids is causing the above observed increase of premature beats or whether both phenomena are merely a result of sympathetic nervous stimulation. Gastric fiberoscopy may be applied to elderly patients with decreased cardiac function. The endoscopic procedure should not be started on the sitting patient but primarily in left supine position.

摘要

对53例患者在进行食管-胃-十二指肠镜检查期间,检测其血压、心率、心电图和血浆游离脂肪酸的变化。23例出现过早搏动,多数情况下仅少量出现。仅5例过早搏动有累积现象,1例出现室性二联律。当最初坐着的患者改为仰卧位时,观察到过早搏动最多。7例患者心电图中ST段压低至少0.1mV,大多是在内镜检查前ST段就已异常的患者。脉搏率平均上升50.1%,收缩压上升14%,舒张压上升17%。总体患者材料中血浆游离脂肪酸的升高无统计学意义,但内镜检查时心电图结果恶化的患者血浆游离脂肪酸升高明显更高。过早搏动次数与血浆游离脂肪酸升高之间有正相关趋势。从我们的研究无法确定游离脂肪酸的动员是否导致上述过早搏动增加,或者这两种现象是否仅仅是交感神经刺激的结果。胃纤维镜检查可应用于心功能减退的老年患者。内镜检查不应从坐着的患者开始,而应主要从左侧卧位开始。

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