抽象
纤维支气管镜(FOB)现在普遍执行,并接受过程老年患者的数量正在增加。与FOB的氧合的问题被大家公认的,但也有关于它的心血管作用的资料很少。45例(平均年龄65岁)择期FOB进行前瞻性研究。患者被连接到12导计算机化心电图记录器,手指体积描记血压(FPBP)显示器和脉搏血氧计。四十三个病人用芬太尼和氟哌利多镇静,并且所有均给予5毫升2.5%可卡因气管内和赛罗卡因喷到咽。平均血压测定袖带血压最初升高(88分之167毫米汞)。通过FPBP记录平均血压升至上气管内注射(96分之178毫米汞柱),并保持整个过程中高。平均(SD)初始心脏频率为93(5.1)拍X分钟(-1),上升至134(7.5)的过程期间X分钟(-1)次。的45名患者的四个显示出> 1毫米> 1分钟,和另外三个发达束支传导阻滞意想不到ST段压低。这七个患者显著更大心动过速(152 VS 131次X分钟(-1))和更高的血压(131分之238VS109分之207毫米汞)。 They were older (72 vs 61 yrs), had smoked more (63 vs 39 pack-years), but had similar lung function and similar changes in oxygen saturation. Oxygen desaturation occurred in 19 patients and this was associated with poor lung function (69 vs 84% predicted forced expiratory volume in one second), but was independent of the cardiovascular changes. Significant cardiovascular changes occur during fibreoptic bronchoscopy, with evidence of cardiac strain in 21% of patients over the age of 60 yrs.