单独丙泊酚静脉麻醉在无痛胃肠镜检查中的效果评价

Effect Assessment of Single Propofol Sedation in Procedures of Painless Gastrointestinal Endoscopy

目的:探讨单独丙泊酚静脉麻醉下胃肠镜检查的可行性、安全性及临床效果。方法:自2009年3月至2009年9月,对800例患者应用丙泊酚进行无痛胃肠镜检查,另外1000例患者进行常规胃肠镜检查,观察两组胃肠镜检查的安全性和效果,检查完后由患者和内镜医生阅读并填写问卷调查表。结果:所有胃肠镜检查均顺利完成。检查前无痛组心理压力明显小于常规组,检查中无痛组不良反应明显比常规组少,两组间对比有显著性统计学差异(P≤0.05);检查后不良反应对比无显著性差异(P>0.05)。常规组检查中出现血压升高和心率增快。无痛组检查中血压、心率均有不同程度下降,与检查前比较有显著差异(P≤0.05),与常规组比较亦存在显著差异(P≤0.05),但多在正常范围,且为一过性,无须特殊处理,检查结束后迅速自行恢复。两组绝大多数患者检查前、中、后SaO2无明显差异,无痛组少部分患者出现SaO2降低,经积极处理迅速恢复正常。结论:单独丙泊酚静脉麻醉下胃肠镜检查是一种安全、舒适、有效的方法,但应注意严格掌握适应证与禁忌证,加强并发症的监测和处理。

Purposes： To discuss the feasibility, safety and clinical effects of single propofol sedation in procedures of painless gastrointestinal endoscopy. Methods： From March 2009 to September 2009, the researchers collected 800 cases of patient with painless gastrointestinal endoscopy and 1000 cases of patient with conventional gastrointestinal endoscopy. Two groups were observed the safety and clinical effects during the operation. After the operation, all patients and endoscopists read and filled out questionnaire. Results： All gastrointestinal endoscopy had been completed successfully. The patients＇mentality pressure of painless group was obviously less than the conventional group before the operation, the adverse reactions of painless group were less than other group during the operation,there was significant difference（ P≤0.05 ） ;there was no significant difference between two groups with adverse reactions after the opration （ P 〉 0.05 ）. During the opration, blood pressure and heart rate increased in conventional group. In painless group, blood pressure and heart rate decreased in different extents during the opration, compared with the foundation status and the conventional group, there was significant difference（ P≤0. 05 ） ,but the change was temporary and remained in the normal range, then returned to normal condition quickly. There was no significant difference of the most patients SaO2. In painless group, a few of patients, SaO2 decreased and quickly returned to normal condition by active treatment. Conclusions： Single propofol sedation in procedures of painless gastrointestinal endoscopy is a safe, comfortable, effective method, but the indications and eontraindications should be noted strictly and the monitoring and treatment of complications should be strengthened.