CAJ | 학술논문

目的探讨老年冠心病患者经鼻胃镜检查的安全性。方法选择2012年1月至2012年12月在北京老年医院接受胃镜检查的65岁以上老年患者100例，分为经鼻胃镜及普通胃镜组（各50例），每组再分为冠心病及非冠心病（各25例），比较各组胃镜检查中心率、血压、血氧饱和度、心肌耗氧量及心电图变化。结果普通胃镜检查中，冠心病患者心率、血压、心肌耗氧量增加较非冠心病患者明显（P＜0.05），血氧饱和度下降值较非冠心病患者高（P＜0.05），冠心病患者心律失常及ST段下移发生率较非冠心病患者高（P＜0.05）；冠心病患者经鼻胃镜检查中，心率、血压、心肌耗氧量增加值较普通胃镜明显低（P＜0.05），血氧饱和度下降值低（P＜0.05），心律失常及ST段下降发生率低（P＜0.05）。结论老年冠心病患者经鼻胃镜检查耐受性好，对心血管影响小，安全性高。
목적탐토노년관심병환자경비위경검사적안전성。방법선택2012년1월지2012년12월재북경노년의원접수위경검사적65세이상노년환자100례，분위경비위경급보통위경조（각50례），매조재분위관심병급비관심병（각25례），비교각조위경검사중심솔、혈압、혈양포화도、심기모양량급심전도변화。결과보통위경검사중，관심병환자심솔、혈압、심기모양량증가교비관심병환자명현（P＜0.05），혈양포화도하강치교비관심병환자고（P＜0.05），관심병환자심률실상급ST단하이발생솔교비관심병환자고（P＜0.05）；관심병환자경비위경검사중，심솔、혈압、심기모양량증가치교보통위경명현저（P＜0.05），혈양포화도하강치저（P＜0.05），심률실상급ST단하강발생솔저（P＜0.05）。결론노년관심병환자경비위경검사내수성호，대심혈관영향소，안전성고。
Objective To determine the safety of transnasal endoscopy for the elderly with coronary heart diseases (CHD). Methods A prospective study was carried out in 100 over-65-year-old patients undergoing gastroscopy in our department from January to December 2012. They were randomly and equally divided into conventional gastroscopy group (n=50) and transnasal endoscopy group (n=50), and then, every group was further divided into CHD subgroup (n=25) and control subgroup (without heart diseases, n=25). The heart rate, blood pressure, arterial oxygen saturation, myocardial oxygen consumption and electrocardiogram during performance of endoscopy were compared between groups. Results During conventional gastroscopy, the increases of heart rate, blood pressure, and myocardial oxygen consumption, and the decrease of arterial oxygen saturation were significantly more obvious in CHD subgroup than the corresponding control subgroup (P<0.05). And, the incidences of arrhythmia and ST segment depression were higher in CHD subgroup than in control subgroup (P<0.05). For those receiving transnasal endoscopy, CHD patients had significantly mild increases in heart rate, blood pressure, and myocardial oxygen consumption, lower arterial oxygen saturation, and decreased incidences of arrhythmia and ST segment depression than the CHD patients undergoing conventional gastroscopy (P<0.05). Conclusion Transnasal endoscopy is well tolerated to elderly patients with CHD, and has fewer hemodynamic effects and higher safety.