动态心电图在食管癌患者调强放疗后诊断中的应用价值(1)
[摘要]目的 探讨动态心电图在食管癌患者调强放疗(IMRT)后诊断中的应用价值。方法 选择2015年1月～2016年12月在中山大学附属肿瘤医院接受IMRT的食管癌患者308例，在放疗前后所有患者均分别实施动态心电图与常规心电图诊断检查，比较两种检查方法的心律失常检出率、对心肌缺血阳性的诊断敏感度、心肌缺血阳性检出率。结果 经放疗后63例患者发生心电图异常，动态心电图的心律失常检出率高于常规心电图，差异有统计学意义(P<0.05);动态心电图的心肌缺血阳性诊断敏感度高于常规心电图，差异有统计学意义(P<0.05);动态心电图的心肌缺血阳性检出率高于常规心电图检出率，差异有统计学意义(P<0.05)。结论 食管癌患者行IMRT后动态心电图与常规心电图变化均具有一定的诊断效果，但是动态心电图明显优于常规心电图。
[关键词]食管癌;调强放疗;动态心电图;常规心电图;临床效果;护理措施
[中图分类号] R735.1 [文献标识码] A [文章编号] 1674-4721(2019)7(c)-0037-04
[Abstract] Objective To investigate the application value of dynamic electrocardiogram in the diagnosis of patients with esophageal cancer after intensity modulated radiation therapy (IMRT). Methods All of 308 patients with esophageal cancer who received IMRT treated in Cancer Hospital Affiliated to Sun Yat-sen University from January 2015 to December 2016 were selected. Before and after radiotherapy， all patients were examined by dynamic electrocardiogram and routine electrocardiogram. The detection rate of arrhythmia， positive detection rate of myocardial ischemia， diagnostic sensitivity and specificity were compared between the two groups. Results All of 63 patients had abnormal electrocardiogram after radiotherapy. The detection rate of arrhythmia in dynamic electrocardiogram was higher than that in conventional electrocardiogram， and the difference was statistically significant (P<0.05). The diagnostic sensitivity of dynamic electrocardiogram for myocardial ischemia was higher than that of conventional electrocardiogram， and the difference was statistically significant (P<0.05). The positive detection rate of myocardial ischemia in dynamic electrocardiogram was higher than that in conventional electrocardiogram， and the difference was statistically significant (P<0.05). Conclusion Dynamic electrocardiogram and conventional electrocardiogram of patients with esophageal cancer after IMRT have certain diagnostic effect， but the dynamic electrocardiogram is significantly better than the conventional electrocardiogram.
[Key words] Esophageal cancer; Intensity modulated radiation therapy; Dynamic electrocardiogram; Routine electrocardiogram; Clinical effect; Nursing measures
食管癌為常见的恶性肿瘤，属于消化道肿瘤疾病。食管癌发生率约为全身恶性肿瘤发生率的3%。目前，食管癌是对人类身体健康造成明显威胁，其病死率及发病率的增高速度均较快。食管癌患者的早期临床症状不典型，大部分食管癌患者发现时，已属中期、晚期，因此，临床针对食管癌一般选择手术治疗[1]、放疗、化疗等，上述三种方式均比较常见，在放疗过程中，肺以及纵隔靶区是食管癌患者放疗的重要区域[2-3]，主要是因为上述靶区比较特殊，容易在治疗过程中出现放疗损伤等，进而使患者的治疗危险性提高，因此需要在进行治疗期间，进行心电图监测[4-5]，基于以上背景，本研究探讨动态心电图在食管癌患者调强放疗(IMRT)后诊断中的应用价值，现报道如下。, http://www.100md.com(唐雪苗 林小玲 邵双玲)
[关键词]食管癌;调强放疗;动态心电图;常规心电图;临床效果;护理措施
[中图分类号] R735.1 [文献标识码] A [文章编号] 1674-4721(2019)7(c)-0037-04
[Abstract] Objective To investigate the application value of dynamic electrocardiogram in the diagnosis of patients with esophageal cancer after intensity modulated radiation therapy (IMRT). Methods All of 308 patients with esophageal cancer who received IMRT treated in Cancer Hospital Affiliated to Sun Yat-sen University from January 2015 to December 2016 were selected. Before and after radiotherapy， all patients were examined by dynamic electrocardiogram and routine electrocardiogram. The detection rate of arrhythmia， positive detection rate of myocardial ischemia， diagnostic sensitivity and specificity were compared between the two groups. Results All of 63 patients had abnormal electrocardiogram after radiotherapy. The detection rate of arrhythmia in dynamic electrocardiogram was higher than that in conventional electrocardiogram， and the difference was statistically significant (P<0.05). The diagnostic sensitivity of dynamic electrocardiogram for myocardial ischemia was higher than that of conventional electrocardiogram， and the difference was statistically significant (P<0.05). The positive detection rate of myocardial ischemia in dynamic electrocardiogram was higher than that in conventional electrocardiogram， and the difference was statistically significant (P<0.05). Conclusion Dynamic electrocardiogram and conventional electrocardiogram of patients with esophageal cancer after IMRT have certain diagnostic effect， but the dynamic electrocardiogram is significantly better than the conventional electrocardiogram.
[Key words] Esophageal cancer; Intensity modulated radiation therapy; Dynamic electrocardiogram; Routine electrocardiogram; Clinical effect; Nursing measures
食管癌為常见的恶性肿瘤，属于消化道肿瘤疾病。食管癌发生率约为全身恶性肿瘤发生率的3%。目前，食管癌是对人类身体健康造成明显威胁，其病死率及发病率的增高速度均较快。食管癌患者的早期临床症状不典型，大部分食管癌患者发现时，已属中期、晚期，因此，临床针对食管癌一般选择手术治疗[1]、放疗、化疗等，上述三种方式均比较常见，在放疗过程中，肺以及纵隔靶区是食管癌患者放疗的重要区域[2-3]，主要是因为上述靶区比较特殊，容易在治疗过程中出现放疗损伤等，进而使患者的治疗危险性提高，因此需要在进行治疗期间，进行心电图监测[4-5]，基于以上背景，本研究探讨动态心电图在食管癌患者调强放疗(IMRT)后诊断中的应用价值，现报道如下。, http://www.100md.com(唐雪苗 林小玲 邵双玲)