依托咪酯联合丙泊酚用于老年患者无痛胃肠镜检查中的效果及对患者认知功能的影响

Effects of etomidate combined with propofol on painless gastroenteroscopy and cognitive function in elderly patients

目的探讨依托咪酯联合丙泊酚用于老年患者无痛胃肠镜检查中的临床效果及对患者认知功能产生的影响。方法选取2016年3月～2017年8月收治我院进行无痛胃肠镜检查的老年患者120例,按照随机数字表法随机分成A、B、C三组,每组40例。对A组患者予以使用依托咪酯,对B组患者予以使用丙泊酚,而对C组患予以同时使用依托咪酯联合丙泊酚进行治疗。分别对三组患者无痛胃肠镜检查期间的各项生命体征指标、患者苏醒时间、患者认知功能以及不良反应发生情况进行比较。结果 (1)各组的SBP、DBP与MAP水平比较差异有统计学意义(P <0.05),且B组患者的SBP、DBP、MAP水平明显低于A、C组患者(P <0.05);(2)各组患者的手术时间、术后苏醒时间以及定向力恢复时间比较差异有统计学意义(P<0.05),且C组患者的手术时间、术后苏醒时间以及定向力恢复时间显著短于A、B组患者(P <0.05);(3)C组患者各种不良反应的发生率均显著低于A组、B组患者,差异有统计学意义(P <0.05);(4)C组患者的各项认知领域的通过率均显著高于A组、B组患者,差异有统计学意义(P <0.05)。结论采用依托咪酯联合丙泊酚用于老年患者的无痛肠镜检查中,能够缩短手术时间和麻醉后苏醒时间,有效的减少不良反应的发生,且能够减少患者术后出现认识功能障碍的情况,值得临床上广泛推广。

Objective To explore the clinical effect of etomidate combined with propofol in painless gastroenteroscopy and cognitive function in elderly patients. Methods 120 elderly patients with painless gastroscopy admitted to our hospital from March 2016 to August 2017 were randomly divided into groups of A,B and C,with 40 cases in each group.The patients in group A were treated with etomidate,and propofol was used in group B,while etomidate combined with propofol was used in group C.In the 3 groups of patients with painless gastroscopy,the life signs,patients' awakening time,the cognitive function of the patients and the incidence of adverse reactions were compared. Results (1)There were significant differences in the SBP,DBP and MAP levels in each group(P < 0.05),and the level of SBP,DBP and MAP in group B was significantly lower than that in the group A and C (P < 0.05).(2)The operative time,the patients of each group after the recovery time and recovery time of orientation were statistically significant(P < 0.05),and operative time,postoperative recovery time and recovery time in group C were significantly shorter than that in groups A and B(P < 0.05);(3)The incidence rate of adverse reactions in the group C was significantly lower than that in groups A and B,the difference was statistically significant(P < 0.05);(4)The pass rate of all cognitive fields in group C was significantly higher than that in group A and B(P < 0.05). Conclusion The application of etomidate combined with propofol in painless colonoscopy of elderly patients can shorten the operation time and the recovery time after anesthesia,effectively reduce the occurrence of adverse reactions,and reduce postoperative cognitive dysfunction in patients,which is worthy of wide promotion in clinical practice.