无痛胃镜检查的临床应用研究

Clinic application study on painless gastroscope inspection

目的研究异丙酚联合小剂量芬太尼、阿托品应用于胃镜检查中的可行性、安全性及副反应。方法180例胃镜检查患者用异丙酚、芬太尼和阿托品静脉复合麻醉为A组,配对的180例常规胃镜检查患者为B组,A组经静脉缓慢推注阿托品0.5mg、芬太尼0.05mg和异丙酚1.5-2mg/kg,直至患者进入4级镇静状态时插入胃镜检查,B组进行常规胃镜检查,两组患者在检查中均给氧。结果A组180例患者全部顺利完成检查,在检查中心率和血压无异常变化,血氧饱和度均维持在98%以上,180例患者(100%)均表示愿意接受再次检查,明显高于B组81例(45%),B组有5例患者因无法忍受而放弃检查,55例患者(30.6%)拒绝再次接受检查。结论异丙酚联合小剂量芬太尼、阿托品用于胃镜检查安全、有效,而且麻醉效果好,意识清醒快,无明显副作用,值得基层医院推广应用。

Objective To study the feasibility, safety and side effect on application of propofol, associated with low dose fentany and atropine with gastresoope inspection. Methods When taking gastroscope inspection, 180 patients receiving propofol, fentanyl and atropine vein multiplex anesthesia consist of group A, while 180 normal gostrescope inspection taking patients as contrasting group. The patients of the group A will be injected atropine 0.5mg, fentanyl 0.05mg and propofol 1.5-2mg/kg slowly through vein until the patients get into the 4 level composure, and insert the gastrescope to exam. Group B Will receive normal gastrescope inspection. Both group will be provided with oxygen. Results 180 patients in group A fulfill the exam task smoothly and their heartbeat rate and blood pressure have no abnormal change and the contents of oxygen saturation in blood maintain over 98%, 100% of the 180 patients agree to have another exam, much higer than that of 81 patients （45%） in group B. 5 patients in group B give up the exam because of unbearable pain, and 55 patients（30.6%） refuse to take another exam. Conclusions the application of propofol, associated with low dose, fentanyl, and atropine in the gastrescope inspection have the characteristics of safety, effectiveness, sound anesthesia effect, quickly-sober consciousness and no apparent side effects, thus it is worthwhile to advocate and adapt by primary hospitals.