老年病人无痛肠镜检查中逆向穿刺静脉留置针的临床应用

Study on the efficacy of reversal retainable venous puncture needle in elderly patients undergoing painless intestinal endoscopy

目的探讨老年病人无痛肠镜检查中应用逆向穿刺针与传统顺向穿刺静脉留置针的临床效果及不良反应。方法选取100例行无痛肠镜检查的老年病人,将其随机分为观察组(50例)和对照组(50例)。观察组采用逆向穿刺留置针静脉推注麻醉剂,对照组则采用传统顺向穿刺留置针。观察2组静脉留置针一次性穿刺成功率、麻醉药注射2min后的镇静评分、肠镜检查中病人出现躁动时的镇静评分、留置针使用中有无药液渗漏,检查前后病人的平均动脉压(MAP)、心率(HR)、血氧饱和度(SPO_2)的变化。结果观察组病人在无痛肠镜检查中镇静评级在2~5级发生率较对照组低,差异有统计学意义(χ~2=4.320,P=0.038)。麻醉后对照组MAP、HR、SPO_2水平显著低于观察组(P<0.05)。结论无痛肠镜检查中使用逆向穿刺静脉留置针推注麻醉剂能提高老年病人肠镜检查中的麻醉效果,减少不良反应。

Objective To compare the clinical effects of reversal venous puncture needle and conventional retainable venous puncture needle in elderly patients during painless intestinal endoscopy.Methods One hundred elderly patients receiving painless intestinal endoscopy were randomly divided into observation group（50 cases） and control group（50 cases）.The observation group received reversal venous puncture needle for anesthetics,and the control group received conventional retainable needle.Successful rate of one-time puncture of venous indwelling needle,sedation score 2 minutes after anesthetic injection,sedation score of patients in the dysphoria state during the enteroscopy,whether there was drug leakage during the usage of indwelling needle were recorded.The levels of mean arterial pressure（MAP）,heart rate（HR）,pulse oxygen saturation（SPO2） of patients before and after examination were observed.Results The incidence rate of sedation rating in the 2-5 degree during painless intestinal endoscopy in observation group was significantly lower than that in control group（χ~2=4.320,P=0.038）.After anesthesia,the levels of MAP,HR,SPO2 of control group were significantly lower than those of observation group（P〈0.05）.Conclusions During painless intestinal endoscopy,infusion of anesthetics using reversal retainable needle can improve the anesthetic effect in elderly patients and reduce adverse reactions.