口服盐酸达克罗宁胶浆复合丙泊酚用于老年患者无痛胃镜检查的临床观察

Observation of the clinical effect of dyclonine with propofol in painless gastroscopy in elderly patients

目的探讨口服盐酸达克罗宁胶浆复合丙泊酚在老年患者无痛胃镜检查中的临床效果。方法2020年7月至2021年3月行无痛胃镜检查的老年患者150例,按随机数字表法分为3组:丙泊酚组(P组)、芬太尼+丙泊酚组(FP组)和达克罗宁+丙泊酚组(DP组),每组50例。DP组患者于胃镜检查前10 min给予口服盐酸达克罗宁胶浆10 ml,含服2 min后咽下;FP组患者于检查前3 min静脉给予芬太尼1μg/kg;3组患者均给予丙泊酚1.5 mg/kg静脉麻醉。记录患者一般资料,胃镜检查时间,麻醉前(T_(1))、胃镜达到贲门时(T_(2))及胃镜全部退出时(T_(3))的MAP、心率、SpO_(2),检查过程中不良反应(呛咳、体动、呃逆及呼吸抑制)发生情况,丙泊酚用量,苏醒时间及操作者满意度评分。结果与T_(1)时比较,P组、FP组T_(2)时MAP、心率、SpO_(2)降低(P<0.05);与T_(2)时比较,P组、FP组T_(3)时MAP、心率、SpO_(2)升高(P<0.05);T_(2)时DP组MAP、心率、SpO_(2)高于P组和FP组(P<0.05)。与P组和FP组比较,DP组体动、呼吸抑制的发生率降低(P<0.05),苏醒时间缩短(P<0.05),操作者满意度评分提高(P<0.05)。FP组、DP组丙泊酚用量低于P组(P<0.05)。其余指标差异无统计学意义(P>0.05)。结论口服达克罗宁胶浆复合丙泊酚用于老年患者无痛胃镜检查,维持血流动力学稳定的同时降低了不良反应的发生率,缩短了苏醒时间,是老年患者无痛胃镜检查麻醉的一种较为安全、可行的麻醉选择。

Objective To investigate the clinical effect of dyclonine combined with propofol in the painless gastroscopy in elderly patients.Methods A total of 150 elderly patients who received the painless gastroscopy in the Second Affiliated Hospital of Xinjiang Medical University were enrolled from Jul 2020 to Mar 2021.All of the patients were divided into three groups according to the random number table method(n=50):propofol group(P group),fentanyl+propofol group(FP group),and dyclonine+propofol group(DP group).The patients in DP group took 10 ml of dyclonine mucilage orally 10 min before the examination,and swallowed it slowly after 2 min in throat.The patients in FP group were injected with fentanyl 1μg/kg intravenously 3 min before the examination.The three groups had 1.5 mg/kg propofol intravenous anesthesia.The general condition and gastroscopy examination time were recorded.The mean arterial pressure(MAP),heart rate,and SpO_(2) were recorded at the time point T_(1)(before dosing),T_(2)(gastroscope reaches the cardia),T_(3)(gastroscope pulled out).This article also recorded the side effects(the occurrence of choking cough,body movement,hiccup,respiratory depression),the propofol consumption,the awakening time,scores of operator satisfaction.Results Compared with those at T_(1) time,the MAP、SpO_(2)、heart rate of patients in the P group and FP group were decreased at T_(2)(P<0.05).Compared with those at T_(2),the MAP、SpO_(2)、heart rate of patients in the P group and FP group are increased at T_(3)(P<0.05).The MAP,heart rate,SpO_(2) in the DP group were higher than those in the P group and FP group at T_(2)(P<0.05).Compared with the P group and FP group,the incidence of body movement and respiratory depression,the awakening time in the DP group was decreased(P<0.05),the scores of operator satisfaction in DP group were higher(P<0.05).The propofol consumption in DP and FP group were lower than those in P group(P<0.05).There was no significant difference in other indicators(P>0.05).Conclusions Dyclonine combined with propofol in elderly patients can maintain the stability of hemodynamics,reduce the incidence of side effects and propofol consumption,and shorten the time of recovery.Therefore,it is safe and feasible anesthesia management for elderly patients in painless gastroscopy.