单纯舒芬太尼镇静镇痛在上消化道出血患者内镜下止血术中的临床应用

Clinical application of sedative analgesia with alone Sufentanil in endoscopic hemostasis in patients with upper gastrointestinal hemorrhage

目的探讨单纯舒芬太尼镇静镇痛用于上消化道出血患者内镜下止血的安全性和有效性。方法选取2016年10月~2017年8月在我院进行上消化道出血行内镜下止血的60例患者,采用电脑随机法分为小剂量舒芬太尼+丙泊酚组(PS组,n=30)和单纯舒芬太尼组(S组,n=30),观察两组患者的麻醉效果、PACU停留时间、生命体征变化、不良事件发生率及患者与内镜医生的满意度。结果 PS组患者的术中心率、平均动脉压、脉搏血氧饱和度下降明显大于S组(P<0.01),PS组患者的严重低血压和严重呼吸抑制发生率高于S组(P<0.01),PACU停留时间也明显长于S组(P<0.01),两组患者的恶心、呕血、呛咳、严重体动发生率比较无明显差异(P>0.05)。两组患者的满意度及内镜医生满意度比较,差异无统计学意义(P>0.05)。结论单纯应用舒芬太尼也能为上消化出血内镜止血术提供良好的手术环境和患者体验,并能提供比复合丙泊酚静脉麻醉更为安全的环境。

Objective To investigate the overall efficacy and safely of sedative analgesia with alone Sufentanil in endoscopic hemostasis in patients with upper gastrointestinal hmnorrhage.Methods 60 patients received endosc, opic hemostasis in our hospital from October 2016 to August 2017 were selected and randomly divided into the low dose Sufentanil ＋ Propofol group （the PS group,n=30） and the Sufentanil group （the S group,n=30）.The anesthesia effect,PACU residence time,vital signs,the incidence rate of adverse events and the satisfaction degree of patients and endoscopic were observed.Results The heart rate,mean arterial pressure and pulse oximetry during surgery of the PS group were significantly higher than those of the S group （P〈0.01）.The incidence rate of severe hypotension and severe respiratory depression in the PS group were higher than that in the S group （P〈0.01）.And the PACU residence time of the PS group was significantly longer than that of the S group （P〈0.01）.There was no significant difference in the incidence rate of adverse events such as nausea,hematemesis,eough,severe physical activity between the two groups.And there was no significant differences in patient satisfaction degree and endoscopic satisfaction degree between the two groups（P〉0.05）. Conclusion Sedative with alone Sufentani] also provides a good surgical environment and patient experience for upper digestive haemorrhagic endoscopic hemostasis and provides a safer environment for intravenous anesthesia than Propofol.