丙泊酚麻醉在内镜下食管静脉曲张硬化剂治疗术的临床观察

The clinical study of Propofol on endoscopic injection of sclerosing agent in esophageal varices

目的:观察使用丙泊酚麻醉下经内镜食管静脉曲张硬化剂治疗术的临床效果。方法:将食管静脉曲张破裂出血的肝硬化患者116例分为无痛麻醉治疗组(A组)和常规治疗组(B组)。A组予静脉注射丙泊酚1～2mg/kg,待患者平静入睡,睫毛反射消失,呼吸、心跳平稳后进行硬化剂治疗术;B组患者直接行经内镜硬化剂治疗,观察并记录胃镜插入时、检查进行5min、拔镜时两组患者血压、心率、呼吸频率、外周血氧饱和度的波动,记录两组手术完成时间和内镜操作医师的满意度。结果:A组患者在3个时间点心率、收缩压、舒张压、呼吸频率和血氧饱和度的波动程度均显著低于B组(P<0.05),内镜操作医师对A组患者的术野暴露、食管蠕动和术中出血情况评估,满意度均明显提高(P<0.05),手术时间也较B组明显缩短(P<0.01)。结论:使用丙泊酚麻醉下经内镜食管静脉曲张硬化剂治疗术使患者的舒适度和安全性提高,内镜操作医师对麻醉状态下术野的满意度较高,术中出血减少,同时缩短了手术的时间。

Objective：To study the clinical effect of Propofol on endoscopic injection of sclerosing a- gent in esophageal varices. Methods： 116 patients with hepatic cirrhosis esophagus varicosity burst bleeds were randomly divided into the painless treated group（group A）, with intravenous Propofol before operation, and normal treated group（grouP B）, without Propofol. The fluctuation of Bp, HR, RR, SpO2 were recorded in three time points, the time consuming and the satisfactory level of operators were compared in the two groups. Results： The fluctuation of Bp, HR, RR, SpO2 in group A were significantly smaller than that of group B（P〈0.05）. The satisfactor tor in handling visual field, esophageal peristalsis and bleeding were higher in group y level of opera- A than group B （P〈0.05）, the time consuming were less in group A（P〈0.01）. Conclusion：Propofol applying to endoscopic injection of sclerosing agent in esophageal varices bring patients more comfort and safe- ty, operators more satisfaction, and less time consuming.