摘要
目的了解异丙酚辅以阿托品静脉麻醉在≥65岁老年人胃肠镜检查中镇静、止痛效果,增加老年患者接受胃镜、肠镜检查的依从性,提高检查的成功率,减少危险性。方法收集4 342例行胃镜检查和1 681例行肠镜检查、年龄≥65岁患者的临床资料,均采用异丙酚辅以阿托品静脉麻醉。记录其操作时间、检查成功率、并发症以及检查前、中、后的血氧饱和度、心率、平均动脉压。结果 4 342例患者胃镜操作时间(6.8±0.6)min、1 681例患者肠镜操作时间(9.3±0.8)min;与检查前比较,检查中患者的心率、平均动脉压差异有统计学意义(P<0.05),但多为短暂一过性,血氧饱和度差异无统计学意义(P>0.05);81.2%(4 891/6 023)的患者注药后平均动脉压、心率、呼吸、血氧饱和度有不同程度下降,进行相应处理后均能顺利完成检查;64%(3 857/6 023)的患者出现注射部位疼痛、23%的患者(1 385/6 023)检查后出现头晕、乏力等一般不需特别处理。99.9%(6 016/6 023)的患者完成检查,患者满意率为99.5%。结论异丙酚辅以阿托品静脉麻醉下进行老年人胃肠镜检查成功率高,有着较高的安全性,患者依从性好、无痛苦、乐意接受。
Objective To evaluate the sedative and analgesic effects of intravenous anesthesia with propofol and atropine in gastrointestinal endoscopy in elderly patients aged 65 years and older,and to improve patient compliance with gastrointestinal endoscopy and examination success rate for reducing the potential risks of gastrointestinal endoscopy.Methods Clinical data of patients aged 65 years and older who underwent gastroscopy（n=4 342） or enteroscopy（n=1 681） under intravenous anesthesia with propofol and atropine were collected.Gastrointestinal endoscopy time,examination success rate,complications,oxygen saturation,heart rate and mean arterial blood pressure were recorded.Results The gastroscopy time and enteroscopy time were（6.8±0.6） minutes and（9.3±0.8） minutes,respectively.Heart rate and mean arterial blood pressure,but not oxygen saturation,obviously changed after endoscopy（P〈0.05）.However,most of these changes were transient.After intravenous anesthesia,different degrees of reduction in mean arterial pressure,heart rate,respiration rate and oxygen saturation were found in 81.2% of patients,who successfully underwent the examination after appropriate treatment.Injection site pain occurred in 64%（3 857） of the 6 023 patients and dizziness and fatigue in 23%（1 385）.A total of 6 016 patients（99.9%） completed the examination.The patient satisfaction rate was 99.5%.Conclusion Gastrointestinal endoscopy can be successfully and safely performed with excellent compliance,painlessness and good acceptance under intravenous anesthesia with propofol and atropine in elderly patients.
出处
《南昌大学学报（医学版）》
CAS
2013年第5期42-45,共4页
Journal of Nanchang University：Medical Sciences
关键词
胃镜
肠镜
异丙酚
静脉麻醉
老年人
gastroscopy
enteroscopy
propofol
intravenous anesthesia
elderly
