镇静／镇痛与麻醉术在沙氏扩张器治疗食管狭窄中的应用

Sedative/analgesic and narcotic in the savary dilator in the treatment of esophageal stenosis

目的探讨镇静／镇痛与麻醉术在沙氏扩张器治疗食管狭窄中的应用价值。方法45例患者分3组：咽部表麻组；清醒镇静组；静脉麻醉组。观察3组不良反应，以及治疗前、治疗中、治疗后血压、呼吸、心率和血氧饱和度变化。结果咽部表麻组精神紧张、呛咳和拔管行为等不良反应明显。术中呼吸、心率及血压有明显升高（P〈0．05），但在正常范围内，血氧饱和度无太大变化；清醒镇静组不良反应明显减少，术中呼吸、心率及血压较术前无明显变化，出现低氧血症2例；静脉麻醉组，术中患者耐受性好，不良反应少；但术中平均血压明显低于术前（P〈0．05）；呼吸、心率比术前有所减慢，但差异无统计学意义（P〉0．05），出现低氧血症4例。结论在内镜治疗中，合理选用镇静／镇痛与麻醉术有利于提高患者的依从性与耐受性，使治疗更加经济、安全、舒适。

Objective To explore the value of Sedative/analgesic and narcotic in the savary dilator in the treatment of esophageal stenosis. Methods 45 cases of patients were divided into 3 groups ： Pharyngeal surface anesthesia group; conscious sedation and intravenous anesthesia, Observation Group 3 patients with adverse reactions, as well as pre-treatment, treatment, treatment of blood pressure, respiration, heart rate and oxygen saturation changes. Results Pharyngeal surface anesthesia group Significant stress,cough, extubation act, and other adverse reactions ,Intraoperative breathing, heart rate and blood pressure increased significantly （P 〈 0. 05 ） , but in the normal range, Oxygen saturation did not change much; Sedation group significantly reduced side effects, patients in breathing, heart rate and blood pressure than before no significant changes occur hypoxemia 2 ; intravenous anesthesia group, patients with intraoperative tolerance, and less adverse reactions ; but the average intra- operative Blood pressure was significantly lower than before （ P 〈 0. 05 ） ; breathing, heart rate than the pre-operative has been slow, but the difference was not statistically significant （ P 〉 0. 05 ） , hypoxemia occurred in 4 cases. Conclusion In the endoscopic treatment, a reasonable choice of sedation / anesthesia and analgesic technique will help improve patient compliance and tolerance,To make treatment more economic, safety, comfort.