摘要
目的 分析评价丙泊酚静脉全凭麻醉在老年无痛消化内镜诊断和治疗中的有效性和安全性。方法 将2011年7月至2013年7月在遂宁市中心医院消化内镜诊疗的80例老年患者,按照随机数字表法分为观察组与对照组,各40例。观察组施行无痛消化内镜诊疗,给予丙泊酚2.0 mg/kg,待睫毛反射消失后进行诊疗,术中根据手术时间和患者反应,酌情追加20~40 mg维持麻醉,手术结束后即停药;对照组施行常规普通消化内镜诊疗。观察记录两组患者术前（T0）、内镜置入（T_1）、术中（T_2）及术毕清醒（T_3）时的收缩压、舒张压、心率和脉搏血氧饱和度（Sp O2）的变化;检测两组患者手术前、后的肺活量（FVC）、第一秒用力呼气量（FEV_1）、最大呼气中期流速（FEF25%~75%）及最大呼气峰值流速（PEF）;内镜诊疗的并发症发生情况。结果 观察组患者的收缩压、舒张压在T_1、T_2下降T_3上升,与此相反,对照组患者的相应指标在T_1、T_2上升T_3下降（P〈0.05）;观察组的心率在各时间点无明显波动,对照组则在T_1、T_2明显升高（P〈0.05）;两组Sp O2指标在T_1、T_2均下降,T_3上升（P〈0.05）。观察组清醒后的FVC、FEV_1、FEF25%~75%、FVC/FEV_1低于对照组[（3.4±0.7）L比（3.8±0.5）L,（2.8±0.5）L比（3.1±0.6）L,（2.6±0.5）L/s比（2.9±0.6）L/s,（77±5）%比（80±4）%],差异有统计学意义（P〈0.05）。观察组并发症发生率显著低于对照组[15.0%（6/40）比62.5%（25/40）],差异有统计学意义（P〈0.05）。结论 丙泊酚静脉全凭麻醉在老年无痛消化内镜诊疗中的效果好,操作简便,对患者循环呼吸的抑制小,苏醒迅速,对肺功能的影响也较小,应用该药物进行老年消化内镜诊疗麻醉安全有效。
Objective To analyze and evaluate the efficacy and safety of total intravenous anesthesia with propofol in elderly patients undergoing painless endoscopy. Methods Total of 80 elderly patients admitted to Suining Central Hospital from Jul. 2011 to Jul. 2013 were divided into an observation group （40 cases） and a control group （40 cases） according to the random number table method. The observation group treated with painless endoscopy received an infusion of 2. 0 mg/kg of propofol, and the endoscopy was per- formed when the eyelash reflex disappeared. The dose of propofol was increased by 20-40 rag according to the time of the endoscopy and body response. Systolic blood pressure （ SBP）, diastolic blood pressure （ DBP）, heart rate（ HR）, oxygen saturation of pulse （ SpO2 ）, forced vital capacity（ FVC）, forced expiratory volume in first second（ FEVI ） ,maximal mld-expiratory flow（ FEF 25% -75% ） and maximum peak expiratory flow rate （PEF） were recorded before, during and after endoscopy. The complications were recorded. Results Systol- ic and diastolic blood pressure of the observation group decreased at TI , T2, then rose at T3 , the correspond- ing index in the control group rose at T1 , T2 ,then decreased at T3 （ P 〈0. 05 ） ;the heart rate of the observa- tion group had no significant fluctuations at all time points and the control group at Ti ,T2 was significantly higher（P 〈 0. 05 ） ; SpO2 of both groups decreased at Tl, T2 then rose at T3 （ P 〈 0. 05 ）. FVC, FEVI, FEF 25 %-75%, FVC/FEV1 after awakening of the observation group were lower than the control group [ （3.4 ± 0.7） Lvs （3.8 ±0.5）L,（2.8±0.5） Lvs （3. 1±0.6） L,.（2.6 ±0.5） L/svs （2.9±0.6） L/s,（77 ± 5） % vs （80 ± 4 ）% 1, the differences were statistically significant （P 〈 0. 05 ）. Complication rate of the observation group was lower than the control group[ 15.0% （6/40） vs 62. 5% （25/40） ] ,the difference was statistically significant （ P 〈 0. 05
出处
《医学综述》
2016年第16期3305-3307,共3页
Medical Recapitulate
关键词
丙泊酚
全凭麻醉
老年消化内镜
Propofol
Total intravenous anesthesia
Endoscopy for the elderly
