乳化依托咪酯与丙泊酚分别复合应用于胃肠镜检查中的比较

Comparison of etomidate and propofol compound used in the examination of gastroscopy and colonoscopy

目的探讨乳化依托咪酯与丙泊酚分别复合应用咪达唑伦+芬太尼在无痛内镜检查中的可行性及安全性比较。方法选择行纤维胃肠镜检查的患者120例,随机分为两组。乳化依托咪酯+芬太尼-咪唑安定混合液组(E组),丙泊酚+芬太尼-咪唑安定混合液组(P组),每组60例,记录两组患者检查前、检查中、检查后5 min SBP、DBP、HR、SpO2的变化,苏醒时间,比较两组各时点血流动力学指标、满意程度、不良反应,术毕对两组患者行(NCSE)认知功能状态的评定。结果E组与检查前相比较SBP、DBP降低6%,HR降低5%。P组检查过程中SBP、DBP均较检查前降低20%,HR降低15%,组内比较差异有统计学意义(P<0.01)。两组间比较有统计学意义(P<0.05)。E组患者主诉有血管刺激症状7例(12%),P组主诉有血管刺激症状36例(60%),两组相比较差异有统计学意义(P<0.01)。苏醒时间及术后认知功能评定差异无统计学意义。结论乳化依托咪酯与丙泊酚分别复合应用咪达唑伦、芬太尼在实施无痛内镜检查时均可达到满意的麻醉效果,但乳化依托咪酯对心血管系统的影响明显小于丙泊酚组,更适合伴有心血管系统疾病的患者行无痛胃肠镜检查。

Objective To investigate the feasibility and safety of Etomidate and Propofol combined with fentanyl and midaziane on painless endoscopic examination. Methods One hundred and twenty cases who underwent the fiber line were randomly divided into two groups. Etomidate combined with fentanyl and midazolam group（E） ,Propofol combined with fentanyl and midazolam group（P） ,each group includes 60 cases. Such changes were recorded that include BP,HP, SpO2 before,in, and after examination in 5 minutes; recovery time; Compared the （NCSE） after the operation of the two groups. Results hemodynamics, satisfaction, adverse reactions, and identified function SBP, DBP were decreased by 6% and HR were decreased by 5% in group E compared with the previous inspection. SBP,DBP were decreased by 20% and HR were decreased by 15% in group P compared with the previous inspection. There were statistic difference in the group （P〈0. 01 ）and between the two groups （P〈 0. 05）. There were 7 patients in group E suffered with symptoms of vascular stimulation,accounting for 12% ,There were 36 patients in group P suffered with symptoms of vascular stimnlation,accounting for 60% ,There were markedly difference in the group （P〈0. 01 ）and significant difference between the two groups（P〈0. 01 ）. There was no significant difference in the recovery time and postoperative recongition function assessment. Conclusion Etomidate and Propofol combined with midaziane and fentanyl in the implementation of painless endoscopic examination can be reached with the anesthetic effect , but the cardiovascular system stimulation of Etomidate is significantly less than Propofol, the patients with the cardiovascular system diseases were adapted to painless examination with Etomidate combined with fentanyl and midazolam.