提高老年患者无痛胃镜检查术中安全性的临床观察

The clinical observation of increasing the safety in elderly patients with painless gastroscopy

目的:总结分析对老年患者行无痛胃镜检查中的临床经验。方法:常规筛选患者,ASAⅠ～Ⅱ级,术前行相关检查。麻醉以芬太尼和异丙酚诱导,待患者生命体征平稳后方行胃镜检查。记录不同检查时段血压、心率、SpO2、及术后离室时间。结果:注药后5min与注药前相比,患者心率、血压有明显下降(P<0.05),注药后10min与注药前相比心率无明显下降(P>0.05),但血压仍明显下降(P<0.05),检查中有2例患者出现中度缺氧(SpO2为60%～80%),22例患者出现轻度缺氧(SpO2为80%～90%)。所有患者离室时间均在30min内。结论:老年患者通过采取辅助人工通气,维持循环稳定等措施,能够更加安全地度过无痛胃镜检查期。

Objective： To summarize and analyze the clinical experience of elderly patients with painless gastroscopy. Methods： Screened the patients routinely whose ASA was form gradeⅠtoⅡand related examinations were checked before the painless gastroscopy. Anesthesia was induced by Fentanyl and Propofol and gastroscopy was checked when the vital signs of the patients were stable. The blood pressure, heart rate, SpO2 and the time leaving from the examination room was recorded in different inspection periods. Results： Compared with those before the injection, the blood pressure and heart rate significantly decreased （P〈0.05） 5 minutes after injection and the heart rate did not decreased obviously 10 minutes after injection（P〉0.05）, while the blood pressure decreased significantly （P〈0.05）. Mild hypoxia occurred in 22 patients （SpO2 80% - 90%）, moderate hypoxia in 2 patients （SpO2 was 60% - 80%）. The time of all patients leaving from the room was within 30 minutes. Conclusion： By taking assisted artificial ventilationand and maintaining the circulation stable and using other methods, elderly patients can be more safely passed the painless gastroscopy period.