摘要
目的：探讨用瑞芬太尼联合依托咪酯对进行胃肠镜检查的老年患者实施麻醉的临床效果。方法：对2014年8月~2015年8月期间在我院接受无痛胃肠镜检查的200例老年患者的临床资料进行回顾性研究。将这200例患者随机分为甲组和乙组,每组各有100例患者。对两组患者均使用胃肠镜进行检查。为甲组患者使用丙泊酚联合芬太尼进行麻醉,为乙组患者使用瑞芬太尼联合依托咪酯进行麻醉。然后,比较两组患者插管后的各项体征指标、各种不良反应的发生率及其术毕至麻醉苏醒的时间和术毕至离开诊室的时间。结果：在插管后,两组患者的各项体征指标均有所降低,但乙组患者的血氧饱和度（Sp O2）、舒张压（DBP）、收缩压（SBP）和心率（HR）均明显高于甲组患者,二者相比差异具有显著性（P〈0.05）。乙组患者各种不良反应的发生率均明显低于甲组患者,二者相比差异具有显著性（P〈0.05）。乙组患者术毕至麻醉苏醒的时间及其术毕至离开诊室的时间均明显短于甲组患者,二者相比差异具有显著性（P〈0.05）。结论：用瑞芬太尼联合依托咪酯对进行胃肠镜检查的老年患者实施麻醉的效果显著,可有效地保持其各项体征指标的稳定,降低其各种不良反应的发生率,且其麻醉后苏醒较快。
Objective ：To investigate the clinical effect of remifentanil and etomidate in elderly patients with gastrointestinal endoscopy in anesthesia. Methods ：From 2015 August to 2014 August, 200 cases of elderly patients with painless gastroscopy and treatment were randomly divided into the observation group and the control group. Anesthetic drugs were remifentanil combined with propofol combined with fentanyl, etomidate, compared two groups of patients with anesthesia. Results ：After anesthesia, the two groups of patients with vital signs index values were reduced. The protective degree（SpO2）, diastolic blood pressure（DBP）, systolic blood pressure（SBP） and heart rate（HR） in the observation group were higher than those in the control group. The incidence of dizziness, nausea, vomiting, respiratory depression, restlessness and cough were 10%, 2%, 3%, 1% and 2% in the observation group, which were lower than those in the control group. The observation group and the control group, compared with the time of recovery and from the room, P〈0.05. Conclusion ：The remifentanil etomidate combined method can stabilize the patient＇s vital signs and avoid too much the heart rate, blood pressure changes, and less adverse reaction, high security and is worthy to be popularized.
