不同联合用药在老年患者无痛胃镜检查中的对比研究

CONTRAST RESEARCH ON COMBINATION THERAPY IN PAINLESS ENDOSCOPY FOR ELDERLY PATIENTS

目的探讨联合芬太尼-丙泊酚、舒芬尼-丙泊酚和依托咪脂-舒芬尼、依托咪脂-丙泊酚-舒芬尼四种静脉药物组合在老年患者胃镜检查中的镇静镇痛效果和安全性。方法将160例接受胃镜检查者随机分为四组,即芬太尼-丙泊酚组(Ⅰ组,40例)、舒芬尼-丙泊酚组(Ⅱ组,40例)和依托咪脂-舒芬尼(Ⅲ组,40例)、依托咪脂-丙泊酚-舒芬尼(Ⅳ组,40例)。观察记录各组受检查前中血压、心率、各种术后不良反应和麻醉药物的用量。结果Ⅰ组,Ⅱ组在术中血压、心率比Ⅲ组,Ⅳ组明显下降,Ⅲ组术中清醒后恶心呕吐明显大于其他三组,有显著性差异(p<0.05)Ⅳ组比Ⅰ、Ⅱ、Ⅲ组的依托咪脂和丙泊酚的用量明显减少(p<0.05)。结论依托咪脂-丙泊酚-舒芬尼联合用药,起效快,恢复时间短,对老年患者血液循环系统稳定,不适反应少,适合门诊老年患者胃镜检查。

Objective To study the combined fentanyl -propofol and propofol and intravenous drugs in elderly patients with gastric microscopic examination of the sedative analgesic efficacy and safety. Methods 160 cases received gastroscopy were randomly divided into four groups, namely fentanyl - propofol group （ I group, n =40）, Shufenni - propofol group （ II group, n =40） and Etomidate - Shufenni （ Ⅲ group ,40 cases）, Etomidate- propofol- Shufenni （IVgroup, n =40）. Observed and recorded by each group before the examination in blood pressure, heart rate, and a variety of adverse reactions after consumption of narcotic drugs. Results Ⅰ Group, Ⅱ group in intraoperative blood pressure, heart rate than Group Ⅲ, Ⅳ group decreased significantly, Ⅲ group of nausea and vomiting after surgery was significantly greater than clear the other three groups, there was significant difference （p 〈0. 05） Ⅳ group than Ⅰ , Ⅱ, Ⅲgroup Etomidate and the amount of propofol significantly reduced （p 〈 0. 05）. Conclusion Etomidate - propofol - Shufenni combination therapy, rapid onset, shorter recovery time, the blood of elderly patients with stable circulatory system, respiratory depression is low, not reactions, suitable for elderly patients with outpatient endoscopy.