Early diagnosis, prevention and treatment of myocardial ischemia during endoscopic retrograde cholangiopancreatography in elderly patients
10.3760/cma.j.issn.0254-9026.2016.02.006
- VernacularTitle:老年患者内镜逆行胰胆管造影术中心肌缺血的早期诊断和药物防治
- Author:
Xuan FANG
;
Yali LI
;
Xinmei CHEN
- Publication Type:Journal Article
- Keywords:
Myocardial ischemia;
Endoscopic retrograde cholangiopancreatography;
Complication
- From:
Chinese Journal of Geriatrics
2016;35(2):137-140
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors and biomarkers for early diagnosis and treatment for myocardial ischemia during endoscopic retrograde cholangiopancreatography (ERCP) in patients aged ≥75 years,in order to improve the effectiveness and security of ERCP.Methods A total of 82 patients undergoing ERCP in our hospital from Jan.2013 to Dec.2014 were divided into the elderly group (n =42,aged≥75 years) and the non-elderly group (n =40,aged ＜75 years).The pre-and post-operative ECG findings,laboratory serological indexes,ERCP operating parameters and post-operative complications were compared between two groups.Results ASA grade was increased in elderly patients as compared with the non-elderly group.The intraoperative hypothermia,preoperative infection and jaundice,and hypertension were risk factors for myocardial ischemia during ERCP.The biochemical indexes including myeloperoxidase,creatine kinase and cardiac troponin Ⅰ were the biomarkers for early diagnosis of myocardial ischemia in patients with non-specific changes of ST-T wave.The indications of anesthesia meeting operation,the consecutive and close anesthesia monitoring,application of nitroglycerin,thermal insulation during operation,oxygen inhalation can effectively relieve myocardial ischemia during ERCP operation.Conclusions The early discovering and effectively treating myocardial ischemia during ERCP can ensure the safe and effectiveness of ERCP in elderly patients aged ≥75 years.
