丙泊酚复合地佐辛与芬太尼用于胃镜检查的效果观察

目的 观察丙泊酚复合地佐辛与芬太尼对比单纯丙泊酚维持用于胃镜检查的临床效果.方法 选择2017年5月至8月胃镜检查患者90例,ASA I～II级.按照随机数字表法分为3组：D组：地佐辛0.05mg/kg复合丙泊酚组;F组：芬太尼1.0μg/kg复合丙泊酚组;C组：单纯丙泊酚组,各30例.记录患者入镜前（T0）、入镜时（T1）、入镜后3min（T2）、入镜后5min（T3）的MAP、HR、SpO2,记录患者术中呛咳、体动情况,呼唤睁眼时长,定向力恢复时间,胃镜检查时长和丙泊酚的用量.结果 T1、T2、T3时D组和F组MAP明显低于C组（P〈0.05）;T1、T2、T3时D组和F组HR明显慢于C组（P〈0.05）;D、F组术中发生呛咳及体动例数均明显少于C组（P=0.00）;D组和F组丙泊酚用量明显低于C组（P=0.00）,呼唤睁眼时长、定向力恢复时长明显短于C组（P=0.00）,且D组呼唤睁眼时间、定向力恢复时间比F组短（P〈0.05）.三组胃镜检查时间,差异无统计学意义.结论 丙泊酚复合地佐辛与芬太尼用于胃镜检查有助于减轻丙泊酚单独应用引起的不良反应,降低丙泊酚使用量,缩短患者术后呼唤睁眼时间、定向力恢复时间,其中地佐辛复合丙泊酚效果更好.

Objective To observe the clinical effect of propoibl combined with dezocine and fentanyl contrast simple propofol maintenance during gastroscopy. Methods 90 patients with ASAI-II underwent gastroscopy in our hospital from May 2017 to August 2017, in accordance with the random number table, were divided into three groups： group D, dezocine 0.05mg/kg combined with propofol group; group F, fentanyl 1.0μg/ kg combined with propofol group; group C, simple propofol group, 30 cases in each group. The MAP, HP,, SpO2 were recorded at the time of TO, T1, T2, Td.Choking cough, body movement, awakening time, directional force recovery time, inspecting time and dosage of propofol were recorded. Results The MAP of group D and group F were significantly lower than group C in T1, T2 and T3 （ P〈0.05 ） .The HR of group D and group F were significantly lower than group C in T1, T2 and T3 （P〈0.05） . The number of choking cough and body movement during operation in group D and F were significantly less than those in group C （ P=0.00 ） ; awakening time, directional force recovery time were significandy shorter than those in group C （ P=0.00 ） , especially in group D were much lower. There was no statistical difference between the three groups in inspecting time. Conclusion Propofol combined with dezocine and fentanyl in gastroscopy can alleviate adverse reaction caused by propofol used alone, lower the dosage ofpropofol, shorter awakening time and directional force recovery time, the more effective one is propofol with dezocine.