摘要
目的探讨小剂量丙泊酚复合表面麻醉对无痛胃镜检查应激反应以及血流动力学产生的影响。方法选取2013年9月至2014年10月在我院接受无痛胃镜检查的患者100例,采用随机数表法将入选患者分为观察组和对照组各50例,对照组患者给予芬太尼麻醉干预,观察组患者给予小剂量丙泊酚复合表面麻醉,比较两组患者治疗后的血浆皮质醇、血糖、收缩压、舒张压、血氧饱和指数、并发症发生率以及麻醉后的镇痛效果。结果治疗后,两组血浆皮质醇、血糖都有所下降,观察组[(235.45±16.89)μg/L、(4.32±0.32)mmol/L]低于对照组[(254.78±21.59)μg/L、(4.98±0.10)mmol/L],两组比较差异显著(P<0.05);观察组发生呛咳、低氧血症、低血压以及心动过缓等并发症低于对照组(P<0.05);两组收缩压、舒张压都有所下降,观察组[(12.03±1.38)kPa、(8.45±1.20)kPa]低于对照组[(16.45±2.19)kPa、(11.02±2.01)kPa)],两组比较差异显著(P<0.05)。两组治疗前后血氧饱和指数比较,差异无统计学意义(P>0.05);观察组麻醉后镇痛效果的总优良率为96.00%,明显高于对照组的72.00%(P<0.05)。结论小剂量丙泊酚复合表面麻醉能在一定程度上抑制患者的应激反应,且有更为稳定的血流动力学。
Objective To investigate the Effects of low dose propofol combined surface anesthesia on stress response and hemodynamics in painless gastroscopy. Methods One hundred patients treated with painless gastroscopy from September 2013 to October 2014 in our hospital were selected. They were randomly divided into the control group and the observation group（n = 50 cases）. The control group received fentanyl anesthesia, and the observation group received low-dose propofol combined surface anesthesia. The plasma cortisol, blood glucose, systolic blood pressure, diastolic blood pressure, blood oxygen saturation index, complication rate and analgesic effect were compared between the two groups after treatment. Results After the treatment, the plasma cortisol, glucose in the observation group was（235.45 ± 16.89 μg/L, 4.32 ± 0.32 mmol/L） which was lower than that in the control group（254.78 ± 21.59 μg/L, 4.98 ± 0.10 mmol/L）. The difference was significant（P〈0.05）. After the treatment, cough, hypoxemia, hypotension and bradycardia complications in the observation group was significantly lower than that of the control group（P〈0.05）. The systolic blood pressure, diastolic blood pressure was decreased in both groups. The observation group was（12.03 ± 1.38 kPa,8.45 ± 1.20 kPa） which were significantly lower than that of the control group（16.45 ± 2.19 kPa, 11.02 ± 2.01 kPa）（P〈0.05）. There was no significant difference in blood oxygen saturation index between the two groups before and after treatment（P〉0.05）. The total excellent rate of the analgesic effect of the observation group was 96%, and that of the control group was 72%. The difference between the two groups was significant（P〈0.05）. Conclusion Low-dose propofol combined with topical anesthesia can inhibit the stress response of the patients to some extent, and has more stable hemodynamics.
出处
《现代消化及介入诊疗》
2017年第2期176-179,共4页
Modern Interventional Diagnosis and Treatment in Gastroenterology
基金
陕西省自然科学基金(ZRY201400020)
