不同药物配伍丙泊酚对无痛胃镜检查男性患者安全性的影响

Effects of different drugs combined with propofol on the safety of painless gastroscopy in male patients

目的:探讨不同药物配伍丙泊酚对无痛胃镜检查男性患者安全性的影响。方法:选取2017年2月至2019年3月在河北省廊坊市第四人民医院行无痛胃镜检查的男性患者180例,将其随机分为丙泊酚组(A组)、右美托咪定+丙泊酚组(B组)、舒芬太尼+丙泊酚组(C组)及纳布啡+丙泊酚组(D组),每组45例。比较4组麻醉前即刻(T0)、镜身过声门(T1)、镜身入消化道3 min(T2)、术毕即刻(T3)、术毕后5 min(T4)、术毕后10 min(T5)时点的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)及Ramsay镇静评分,并记录患者术中、术后不良反应。结果:B组、C组和D组T1时HR、MAP低于A组,T1时Ramsay评分和T2时MAP、SpO2高于A组(均P<0.05)。B组T1~T3时HR低于其余各组(P<0.05),T1~T3时Ramsay评分高于其余各组(P<0.05)。B组、C组和D组丙泊酚用量少于A组,患者苏醒时间短于A组,呛咳呃逆、体动反应、呼吸抑制、低血压的发生率低于A组(均P<0.05);B组窦性心动过缓发生率高于其余各组(P<0.05)。D组恶心、呕吐发生率低于其余各组(P<0.05)。结论:在男性患者无痛胃镜检查中,丙泊酚复合纳布啡的临床效果及安全性优于单独使用丙泊酚或丙泊酚复合右美托咪定以及丙泊酚复合舒芬太尼。

Objective:To explore the effects of different drugs combined with propofol on the safety of painless gastroscopy in male patients.Methods:A total of 180 male patients receiving painless gastroscopy in our hospital from February 2017 to March 2019 were selected and divided randomly into four groups:group A(propofol),group B(dexmedetomidine+propofol),group C(sufentanil+propofol)and group D(nalbuphine+propofol).Heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation(SpO2)and Ramsay sedation score immediately before anesthesia(T0),at the time of lens barrel through the glottis(T1)and lens barrel into the digestive tract for 3 min(T2),immediately after surgery(T3),5 min after surgery(T4),and 10 min after surgery(T5)as well as the intraoperative and postoperative adverse reactions were compared.Results:HR and MAP at T1 in group B,C and D were lower than those in group A(P<0.05),while MAP and SpO2 at T2 were higher(P<0.05).HR at T1 to T3 in group B was lower than that in other three groups,and Ramsay score at T1 to T3 was higher(P<0.05).The dosage of propofol was lower,the recovery time was shorter and the incidence of hiccup,somatic response,respiratory depression and hypotension was lower in group B,C and D than those in group A(P<0.05).The incidence of sinus bradycardia in group B was higher than that in other three groups(P<0.05).The incidence of nausea and vomiting in group D was lower than that in other three groups(P<0.05).Conclusion:For male patients undergoing painless gastroscopy,the clinical effect and safety of propofol combined with nalbuphine were better than that of propofol alone or propofol combined with dexmedetomidine or propofol combined with sufentanil.