不同赋形剂异丙酚用于老年人胃肠镜检查的临床研究

The Clinical Study of Applying Different Excipient Propofols in Ederly Patients' Gastrointestinal Endoscopy Examination

目的:讨探不同赋形剂异丙酚对老年人胃肠镜检查的影响。方法:将择期行胃肠镜检查老年患者80例随机分为两组(n=40):异丙酚中、长链甘油三酯注射液(MCT/LCT)为M组;异丙酚长链甘油三酯(LCT)为L组。麻醉开始,M组静脉推注异丙酚(MCL/LCT)2.5mg/kg;L组静脉推注异丙酚(LCT)2.5mg/kg;3min后,全部病例静脉推注芬0.05mg,待患者意识消失后开始胃肠镜检查。术中根据需要随时追加相应的异丙酚至手术结束。记录静脉推注异丙酚时,患者疼痛反应情况及其用量。术前及术后采集静脉血样,测定血浆甘油三酯(TG)、总胆固(CH)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)浓度及AST、ALT活性。结果:L组静脉推注痛及术后血浆TG、CH明显增高(P<0.05),也明显高于M组(P<0.05);两组HDLC、LDLC及AST、ALT活性变化均无显著差异(P>0.05)。结论:两种不同赋形剂异丙酚虽然对肝功能影响无差异,但异丙酚中、长链甘油三酯注射液对血脂影响小,静脉推注疼痛轻,更有益于老年患者。

Objective:To discuss the influences of different excipients propofolsonelderly patients' gastrointestinal endoscopy examination.Methods:80elderly patients who were to receive gastrointestinal endoscopy examinationwere randomly divided into two groups(n=40):MCT/LCT of propofol was group M and LCT of propofol was group L.After the anesthesia,patients in group Mreceived intravenous injection propofol(MCT/LCT)2.5mg/kg and patients in group Lreceived intravenous injection propofol(LCT)2.5mg/kg;after 3min,all patients in both groups received intravnous injectionfentanyl 0.05 mg,gastrointestinal endoscopy examination starts after patients' consciousness disappeared.During the surgery,corresponding propofol was added when necessary.In the intravnous injection,patients' pain reaction and usage were recorded.Venous blood samples were colleced before and after the surgery to determine concentration of TG,CH,HDLC and LDLC and the activity of AST and ALT.Results:In group L,TG,CH and intravnous injection pain increased significantly after surgery(P<0.05),they were also significantly higher than those of group M(P<0.05).There were no significant differences between the two groups in HDLC,LDLC as well as activity changes of AST and ALT(P>0.05).Conclusion:The effects of two kinds of excipientspropofol on liver function have no difference.Propofol MCT/LCT exerts less effect on blood lipid,has less pain in intravnous injectionand is more suitable for elderly patients.