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Journal of the Korean Academy of Family Medicine 2003;24(12):1099-1103.
Published online December 10, 2003.
Changes of Blood Pressure during Endoscopy.
Young In Lee, Hyun Ah Park, Yong Hyun An, Hyeong Jun Kim, Sang Keun Hahm
Department of Family Medicine, Hanil General Hospital, Korea. parkhyunah@hananet.net
내시경 전후의 혈압 변화
이영인,박현아,안용현,김형준,함상근
한일병원 가정의학과
Abstract
Background
: The burden of cardiac complications during endoscopy are growing due to increasing proportion of elderly in the endoscopy target population. This study was conducted to examine the blood pressure changes before and after the endoscopy and to seek better pre-treatments in minimizing cardiac complications.

Methods : One hundred subjects were chosen by consecutive sampling who visited a general hospital for physical examination. Basal, pre-endoscopic, immediate post-endoscopic blood pressure and blood pressure after 10 and 30 minutes were measured utilizing manual BP cuffs and recorded.

Results : The subjects included 34 hypertensive patients. Twelve subjects were on anti hypertensive medication. In 5 consecutive measurements, significant variations on blood pressure was noted (P<0.01). Blood pressure kept increasing until immediately after the procedure, followed by a gradual reduction. These changes were observed in both the normotensive and the hypertensive group, but the degree of changes were more pronounced in the hypertrensive group than the normotensive group (P<0.01). The difference between basal and after procedure was 17.6 mmHg for systolic, 13.5 mmHg for diastolic in the normotensive group. However in the hypertensive group, the difference was 21.4 mmHg for systolic, 14.8 mmHg for diastolic. In comparison of medicated and non-medicated group in the hypertensive patients, the degree of changes were marginally, but significantly lower in the treatment group than in the non-treatment group (systolic P=0.056, diastolic P=0.049).

Conclusion : The stress during endoscopy resulted in blood pressure changes, and the degree of changes was higher in the hypertensive group than the normotensive group. In the hypertensive group, the degree of changes was lower in patients treated with anti hypertensives than the non-treated patients. This sample size, however, was small.
Key Words: blood pressure change, endoscopy, hypertensive group, normotensive group, anti hypertensive
초록
연구배경 : 내시경 대상자의 연령이 높아지면서 심혈관계 합병증에 대한 부담이 증가되고 있는 현실에서 본 연구는 내시경 전후의 혈압 변화를 알아보고 그에 따른 적절한 전 처치를 모색하기 위하여 시행하였다.

방법 : 일개 종합 병원 종합 검진 대상자 100명을 연속적으로 추출하여 수은 혈압계로 기저, 내시경 직전, 내시경 직후, 내시경 10분 후, 내시경 30분 후 각 혈압을 측정하였다.

결과 : 대상자 중 34명이 고혈압 환자였으며 그중 12명만이 당일 아침 항고혈압제를 복용하였다. 5회 연속 측정한 수축기 혈압과 이완기 혈압은 정상혈압군과 고혈압군에서 모두 유의하게(P<0.01) 기저에서 내시경 직후까지 증가하다가 이후 감소하는 변화를 보였으며, 군 간 비교에서는 고혈압군에서 유의하게(P<0.01) 더 큰 폭의 변화를 보였다. 정상혈압군에서는 내시경 후, 수축기 혈압은 17.6 mmHg, 이완기 혈압은 13.5 mmHg 상승하였으며 고혈압군에서는 내시경 후, 수축기 혈압은 21.4 mmHg, 이완기 혈압은 14.8 mmHg 상승하였다. 고혈압군을 다시 당일 아침 항고혈압제를 복용한 군과 복용하지 않은 군으로 나누어 비교한 결과 경계선 상의 유의성(수축기 P=0.056, 이완기 P=0.049)을 가지고 항고혈압제를 복용한 군에서 혈압 변화가 적었다.

결론 : 내시경으로 인한 스트레스가 혈압 증가를 일으켰으며, 그 증가 정도는 고혈압군에서 더 높았다. 한편 항고혈압제를 복용한 군에서는 그 증가 정도가 적어지나 표본수가 적어 일반화하기는 어렵다.
중심 단어: 혈압 변화, 내시경, 고혈압군, 정상혈압군, 항고혈압제


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