胃镜检查中应激反应的临床对照分析

Effects of Psychological Intervention and Sedative on Stress Response to Gastroscopy

目的 :研究心理干预和镇静技术对胃镜检查患者应激反应的影响。方法 :胃镜检查患者 86例 ,随机分为 3组 :心理干预组 ( 2 9例 ) :用多媒体技术进行心理干预 ;镇静组 ( 2 9例 ) :予咪唑安定和异丙酚镇静 ;对照组 ( 2 8例 ) :予常规操作。观察各组检查反应、BP、HR、SpO2 、去甲肾上腺素 (NE)、肾上腺素 (E)、多巴胺 (DA)和皮质醇 (CS)变化。结果 :对照组检查中不适反应发生率较高 ,BP、HR、NE、E与CS明显升高。心理干预组和镇静组不适反应发生率较对照组低 (P <0 0 1、 0 0 5 ) ,且BP、HR、NE、E与CS无明显升高。结论 :心理干预和镇静技术可降低胃镜检查患者的应激反应。

Objective:To study effects of psychological intervention and sedativn on stress response to gastroscopy.Methods:86 patients for gastroscopy were randomly divided into three groups:29 patients in group of psychological intervention watched video materials about psychological intervention before gastroscopy;29 patients in sedative group were given intravenous midazolam and propofol.; 28 patients in control group were no psychological intervention or sedation. Patient's discomfort and changes of blood pressure(BP),heart rate(HR) , saturation of pulse oxygen(SpO 2) were recorded. The level of norepinephrine(NE), adnephrin(E), dopamine(DA) and cortisol(CS)in serum were detected.Results:The incidence of cough,nausea and vomiting, and restlessness in group of psychological intervention and in sedative group was lower as compared with the control group. BP,HR,NE,E and CS in control group rose significantly during the procedure while that of patients in group of psychological intervention and in sedative group was no significant change.Conclusion:The psychological intervention or sedation with midazolam and propofol can reduce stress response to gastroscopy.