无痛消化内镜在高龄老年患者中的应用

Painless gastrointestinal endoscopy in the elderly patients

目的探讨高龄老年患者行无痛消化内镜诊治的安全性。方法 318例年龄≥80岁老年患者行无痛消化内镜检查,检查时应用舒芬太尼或咪唑安定联合异丙酚进行镇痛。结果本组患者均顺利完成消化内镜检查/治疗;实施胃镜检查249例,其中治疗92例;肠镜检查69例,其中治疗47例;检查中舒芬太尼或咪唑安定和异丙酚应用剂量均较成人剂量减少,且注射速度缓慢,其镇静程度可控制在RamsayⅢ～Ⅳ级。结论将适量舒芬太尼或咪唑安定联合异丙酚作为麻醉镇痛剂,应用于年龄≥80岁高龄老年患者消化内镜检查安全、有效,可提高患者检查的舒适度,有利于诊治的顺利进行。

Objective To study the safety of painless gastrointestinal endoscopy in the elderly patients.Methods A total of 318 patients aged 80 years or older received gastrointestinal endoscopy.The combined application of sufentanil or midazolam and propofol was used in digestive endoscopic procedures.Results Gastroscopy was performed in 249 cases for diagnosis and in 92 cases for therapy.Colonoscopy was performed in 69 cases for diagnosis and 47 cases for therapy.Sufentanil or midazolam and propofol were used in all endoscopic procedures.The administration dose was lower than that in adults,the and administration velocity was slow.The calm degrees were controlled between Ramsay 3 to 4.Conclusion It is safe and effective for patients aged 80 years or older to administrate defined amount of sufentanil or midazolam and propofol in the painless gastrointestinal endoscopic procedures.