“清醒”状态下的无痛肠镜与传统无痛肠镜的临床对比研究

A study about clinic effect comparison on traditional painless colonal endscope and painless colonal endscope under the state of "awake"

目的探索在"深镇痛"下保持患者清醒状态进行肠镜检查相对于传统的无痛肠镜检查的优势。方法选取2010年4月～2011年10月来我院进行肠镜检查的145例患者。观察组75例采用帕瑞昔布、山莨菪碱复合芬太尼对患者进行"深镇痛"后进行肠镜检查;对照组70例采用传统的丙泊酚复合芬太尼对患者进行"深镇静"后进行肠镜检查。观察比对两组患者不同时间点的心率、血压、呼吸情况和清醒时间、术后不良反应、离室观察时间等差异以及患者的满意度。结果两组患者术中的心率改变差异无统计学意义(P>0.05),但血压、呼吸频率及血氧饱和度改变情况差异有统计学意义(P<0.05);离室观察时间和术后清醒时间观察组明显小于对照组(P<0.05);术后不良反应的总发生率观察组小于对照组(P<0.05);患者的满意程度观察组与对照组差异不明显(P>0.05)。结论采用帕瑞昔布复合山莨菪碱对受检者进行"深镇痛"后行肠镜检查术,不仅能够达到无痛效果,而且能有效地避免传统无痛肠镜"深镇静"麻醉下对呼吸和循环系统的抑制,患者配合好,安全性更高,值得进一步推广。

Objective To explore the advantage of painless colonal endoscope under the awake state within ＂deep analgesia＂ compared with traditional painless colonal endscope.Methods Choose 145 patients in our hospital for endoscopic check from 2010/4 to 2011/10.The observation group（75 patients） receive parecoxib and raceanisodamine hydrochloride with fentanyl for ＂deep analgesia＂ and then go endoscopic check;another control group（70 patients） receive traditional propofol compound fentanyl and then go endoscopic check.To observe the heart rate,blood pressure,respiratory conditions and sober time,postoperative adverse reactions,observation time after leaving room and patients′satisfaction.Results The heart rate change is not obvious（P0.05）,changes in blood pressure,breath rate and blood oxygen saturation is obvious（P0.05）;observation time after leaving room and sober time after operation are less than that in control group（P0.05）;the total incidence of postoperative adverse reaction in observation group are more than that in control group（P0.05）;There is no significance of satisfaction between two groups（P0.05）.Conclusion Parecoxib and raceanisodamine hydrochloride with fentanyl for ＂deep analgesia＂ and then going endoscopic check could not only be painless,but also avoid the inhibition of traditional painless colonal endoscope to breath and circulation system,worth further promotion.