异丙酚靶控镇静在消化内镜应用的临床研究

Application of propofol target controlled infusion for digestive endoscopy

目的研究异丙酚靶控镇静下,行消化内镜患者术中、术后情况变化,探讨异丙酚靶控镇静在消化内镜治疗时的临床应用价值。方法选择2009年5月—2011年5月60例需行消化内镜检查或治疗的患者,采用异丙酚靶控镇静,持续监测并记录患者术前、置入内镜后1min至术后10min的心率(HR)、经皮血氧饱和度(SPO2)、收缩压/舒张压(SBP/DBP)。记录内镜术持续时间,术后至Ramsay≤Ⅱ级时间及手术30min后患者对治疗过程的术中表现和主观回忆。结果异丙酚靶控诱导剂量时,患者HR、SBP/DBP、RR有所下降,与治疗前比较,差异有统计学意义(P<0.05),置入内镜后1min及术后10min时心率、SBP/DBP与诱导剂量时比较,差异有统计学意义(P<0.05),全程SPO2>95%。苏醒时间短,术中躁动1例(1.6%),恶心9例(15%),呕吐0例(0%),呛咳5例(8.3%),痛苦回忆2例(3.3%)。结论异丙酚靶控镇静在内镜治疗中可有效改善患者应激状态,减少躁动、恶心、呕吐等相关副反应,术后苏醒快,痛苦记忆存留少,是较好的介入性操作的镇静方式。

Objective To investigate the effect of disoprofol target controlled infusion for digestive endoscopy.Methods 60 cases of patients treated by digestive endoscopy use of propofol sedation. Monitoring and recording of the heart rate, transcutaneous oxygen saturation, systolic/diastolic blood pressure in patients before and after surgery in 1min,10min from May 2009 to May 2011 in our hospital. Recording the surgery time, the time to Ramsay≤Ⅱand process memory 30 minutes after surgery. Results The HR, SBP/DBP, RR decreased in propofol induction dose.There was statistically significant difference compared with before treatment,（P 95% in surgery. Recovery time was short.Intraoperative restlessness in 1 case （1.6%）, nausea in 9 cases （15%）, vomiting 0 cases （0%）, cough in 5 patients （8.3%）, painful memories had 2 cases （3.3%）. Conclusion Propofol target controlled infusion can effectively improve the stress state of patients who treated by digestive endoscopy, reducing the related side effects, such as restless, nausea and vomiting, awakening fast after operation, no pain memories, which is a good way of calm when the patients need digestive endoscopy.