艾司氯胺酮对无痛胃肠镜检查患者围检查期应激反应的影响分析

The Effect of Esketamine on Peri-examination Stress Response in Patients Undergoing Painless Gastrointestinal Endoscopy

目的探讨艾司氯胺酮对无痛胃肠镜检查患者围检查期应激反应的影响。方法方便选取2021年1—11月该院无痛胃肠镜检查患者102例,依据简单随机数表法分为研究组与对照组,各51例。对照组无痛胃肠镜检查中用丙泊酚进行麻醉诱导,研究组在对照组基础上用艾司氯胺酮进行麻醉诱导;统计两组检查相关用时及丙泊酚追加例数、围检查期血压及心率、应激反应指标水平、不良反应。结果研究组置入胃肠镜用时(80.46±20.34)s短于对照组,丙泊酚追加例数21例(41.18%)少于对照组,差异有统计学意义(t=3.216,χ^(2)=3.923,P<0.05),两组检查操作用时、苏醒时间、离开恢复室时间差异无统计学意义(t=0.366、0.208、0.156,P>0.05)。检查中、检查后研究组心率[(94.22±6.79)、(89.89±7.74)次/min]、舒张压[(87.45±7.24)、(89.34±5.40)mmHg]、收缩压[(122.53±6.81)、(123.41±5.61)mmHg]优于对照组(t=7.377、3.778、2.760、2.290、4.250、3.300,P<0.05)。检查中、检查后研究组血糖[(6.29±0.60)、(5.69±0.59)mmol/L]及皮质醇[(296.37±46.45)、(216.27±24.55)nmol/L]低于对照组,差异有统计学意义(t=4.288、2.625、8.491、8.904,P<0.05)。研究组不良反应发生率(5.88%)低于对照组(29.41%),差异有统计学意义(χ^(2)=9.714,P<0.05)。结论无痛胃肠镜检查中应用艾司氯胺酮可抑制血压、心率、血糖及皮质醇含量波动,减少丙泊酚追加次数,减轻围检查期应激反应程度,利于缩短置入胃肠镜用时,且能降低不良反应发生率。

Objective To investigate the effect of esketamine on peri-examination stress response in patients undergoing painless gastrointestinal endoscopy.Methods A total of 102 patients with painless gastrointestinal endoscopy in the hospital from January to November 2021 were conveniently selected and divided into a study group and a control group according to the simple random number table method,with 51 cases in each.In the control group,propofol was used for anesthesia induction during painless gastrointestinal endoscopy,while the study group was treated with esketamine for anesthesia induction on the basis of the control group.The examination-related time,the number of additional cases of propofol,the blood pressure and heart rate during the peri-examination period,the levels of stress response indicators,and adverse reactions were counted between the two groups.Results The time for gastrointestinal endoscopy in the study group was(80.46±20.34)s shorter than that in the control group,and the number of additional cases of propofol 21 cases(41.18%)was less than that in the control group,the difference was statistically significant(t=3.216,χ^(2)=3.923,P<0.05).There was no statistically significant difference in operation time,recovery time,and time out of the recovery room(t=0.366,0.208,0.156,P>0.05).During and after the examination,the heart rate of the study group[(94.22±6.79)times/min,(89.89±7.74)times/min],diastolic blood pressure[(87.45±7.24)mmHg,(89.34±5.40)mmHg],systolic blood pressure[(122.53±6.81)mmHg,(123.41±5.61)mmHg]were better than the control group,the difference was statistically significant(t=7.377,3.778,2.760,2.290,4.250,3.300,P<0.05).Blood glucose[(6.29±0.60)mmol/L,(5.69±0.59)mmol/L]and cortisol[(296.37±46.45)nmol/L,(216.27±24.55)nmol/L]in the study group were low than that in the control group during and after the examination,the difference was statistically significant(t=4.288,2.625,8.491,8.904,P<0.05).The incidence of adverse reactions in the study group(5.88%)was lower than that in the control group(29.41%),the difference was statistically significant(χ^(2)=9.714,P<0.05).Conclusion The application of esketamine in painless gastrointestinal endoscopy can inhibit the fluctuation of blood pressure,heart rate,blood sugar and cortisol content,reduce the number of additional propofol,reduce the degree of stress response during the peri-examination period,help shorten the time for gastrointestinal endoscopy and can reduce the incidence of adverse reactions.