丙泊酚和芬太尼在老年高血压患者无痛胃镜检查中的应用研究

Joint application of propofol and fentanyl in elderly patients with hypertension receiving painless gastroscopic examination

目的探讨丙泊酚和芬太尼联合应用在老年原发性高血压(高血压)患者无痛胃镜检查中的有效性和安全性。方法选取81例行胃镜检查的老年高血压患者,40例静脉注射芬太尼和丙泊酚的患者设为观察组,41例行普通胃镜检查的患者设为对照组。记录两组的检查时间、收缩压、舒张压、心率、脉搏氧饱和度。观察时间点:检查前(T0)、准备进镜前(T1)、胃镜经食道入口平面(T2)、胃镜取活检(T3)、检查后(T4)。结果两组治疗前收缩压、舒张压、心率、脉搏氧饱和度及检查时间比较,差异无统计学意义(P>0.05)。观察组检查过程中的收缩压、舒张压、心率较检查前显著下降,差异有统计学意义(P<0.05);且明显均低于对照组检查过程中对应的时间点;但脉搏氧饱和度变化幅度不大,与检查前比较,差异无统计学意义(P>0.05)。结论丙泊酚和芬太尼联合应用于老年高血压患者胃镜检查是安全、有效的。

Objectives To explore the effectiveness and safety of joint application of propofol and fentanyl in elderly patients with hypertension in painless gastroscopic examination. Methods Totally 81 cases who received gastroscopic examination were divided into 2 groups ： 40 cases undertaking combined anesthesia of propofol and fentanyl in observation group and 41 cases undertaking routine procedures in control group. Duration of examination, blood pressure, heart rate and oxygen saturation were observed and recorded in the two groups. Time points of the observation were as follows： before examination （To）, before gastroscope entrance （T1）, gastroscope reached the entrance of esophagus （T2）, gastroscopic biopsy （T3）, after examination （T4）. Results There were no significant differences of duration of examination, blood pressure, heart rate and oxygen saturation between the two groups （/9〉0.05）. Blood pressure and heart rate were significantly lower in observation group after examination （P〈0.05） and significantly lower than those in control group at the corresponding time points during examination （P〈0.05） ; but oxygen saturation had no significant differences before and after examination （P〉0.05）. Conclusions It is safe and effective to use combinned anesthesia of propofol and fentanyl in gastroscopic examination in elderly patients with hypertension.