摘要
目的:观察依托咪酯复合丙泊酚在老年患者无痛胃镜中应用的安全性和有效性。方法:将200例要求行无痛胃镜检查的老年患者随机分成A、B组,各100例。诱导期A组给予芬太尼0.04 mg、丙泊酚1.5 mg/kg静脉分次注射,B组给予芬太尼0.04 mg、丙泊酚0.8 mg/kg静脉注射,数秒后再注射依托咪酯0.2 mg/kg。如检查过程中需追加药物,以丙泊酚0.5 mg/kg追加维持。观察麻醉前后2组患者血压、心率、动脉血氧饱和度(SpO2)、呼吸幅度和频率、胃壁蠕动、反流恶心和肌颤发生情况。结果:2组均顺利完成胃镜检查。麻醉后A组的平均动脉压、SpO2均较注射药物前和麻醉后B组显著下降(P<0.01)。2组肌颤、反流呕吐发生差异均无统计学意义(P﹥0.05)。结论:在老年患者无痛胃镜中,依托咪酯复合丙泊酚可明显降低术中呼吸、循环抑制的发生率;反流、呕吐和肌颤发生率低,安全性高,具有一定的临床价值。
Objective ：To observe the clinical effects and safety of application of etomidate combined with propofol in gastroscopy for elderly patients. Methods ：Two hundred gastroscope inspection cases were randomly divided into group A and group B （100 cases in each group）. The cases of group A were injected with 0.04 mg of fentanyl and 1.5 mg/kg of propofol. The cases of group B were injected with O. 04 mg of fentanyl and 0.8 mg/kg of propofol. After a few seconds ,0.2 mg/kg of etomidate was added if necessary,0.5 mg/kg of propofol was given again. Blood pressure, heart rate, SpO2 and respiratory amplitude and frequency, gastral peristalsis, amyostasia and reverse flow nausea of all cases were recorded before and after anesthesia. Results： Both groups successfully completed gastroscope inspection. Various indexes of respiratory and circulation of all cases were not statistically significant（P 〉 0.05） before and after anesthesia. The MAP and SpO2 of group A after anesthesia significantly decreased than that of group A before anesthesia and group B（P 〈0.01 ）. The occurrences of amyostasia and reverse flow nausea of two groups were not significant different （P 〉 0.05 ）. Conclusions：Etomidate combined with propofol in gastroscopy can significantly decrease the occurrences of espiratory and circulation suppressor, amyostasia and reverse flow nausea and Increase asafety. Awakening time of two groups have no significant difference. The application of propofol combineded with etomidate in gastroscopy for elderly patients is of certain clinical value.
出处
《蚌埠医学院学报》
CAS
2012年第6期702-704,共3页
Journal of Bengbu Medical College
