摘要
目的对比不同药物配伍麻醉用于老年患者无痛胃镜检查的临床效果及安全性。方法将160例拟行无痛胃镜检查的老年患者通过随机数字表法分为RP组(瑞芬太尼+异丙酚+利多卡因)和DRE组(地佐辛+瑞芬太尼+依托咪酯),每组80例。其中RP组男44例,女36例,年龄65.48±5.98岁;DRE组男40例,女40例,年龄66.19±5.13岁。比较两组胃镜置入时间、胃镜检查时间、患者苏醒时间和患者离院时间。观察两组胃镜检查前(T0)、胃镜检查中(T1)和胃镜检查后(T2)的收缩压、舒张压、心率、呼吸频率和血氧饱和度。于T0、T2检测两组血浆C反应蛋白及皮质醇、去甲肾上腺素浓度水平。比较两组麻醉效果及不良反应。记录操作者满意度、麻醉医师满意度及患者舒适度。结果两组患者胃镜置入时间、胃镜检查时间、患者苏醒时间和患者离院时间差异无统计学意义(P>0.05);两组T0时收缩压、舒张压、心率、呼吸频率、血氧饱和度差异无统计学意义(P>0.05),T1、T2时RP组收缩压、舒张压低于DRE组(P<0.05),T2时心率低于DRE组(P<0.05),T1时血氧饱和度低于DRE组(P<0.05)。与T0时比较,两组T2时C反应蛋白皮质醇、去甲肾上腺素水平增高,但DRE组增高幅度低于RP组(P<0.05)。两组麻醉效果差异无统计学意义(P>0.05)。DRE组低血压发生率低于RP组(P<0.05),肌颤发生率高于RP组(P<0.05)。两组操作者满意度、患者舒适度差异无统计学意义(P>0.05),DRE组麻醉医师满意度高于RP组。结论依托咪酯复合瑞芬太尼及小剂量地佐辛用于老年患者无痛胃镜检查,在稳定血流动力学、减轻应激反应及提升患者舒适度方面优于异丙酚复合瑞芬太尼及利多卡因。
Objective To compare the clinical effect and safety of different drugs combined with anesthesia for painless gastroscopy in elderly patients.Methods A total of 160 elderly patients who planned to undergo painless gastroscopy were randomly divided into RP group(remifentanil+propofol+lidocaine)and DRE group(dizocine+remifentanil+etomidate),with 80 casesin each group.RP group included 44 males and 36 females,with the average age of 65.48±5.98 years old.DRE group included 40 males and 40 females with the average age of 66.19±5.13 years old.The two groups were compared in terms of the time of endoscopic implantation,the time of gastroscopy examination,the time of patients'waking up and the time of patients'leaving hospital.Systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),respiratory rate(RR)and blood oxygen saturation(SpO2)of the two groups before gastroscopy(T0),during gastroscopy(T1)and after gastroscopy(T2)were compared.Plasma C-reactive protein(CRP),cortisol(Cor)and norepinephrine(NE)levels were measured before(T0)and after(T2)gastroscopy.The anaesthesia effect and adverse reactions during and after operation were compared between the two groups.Operator satisfaction,anesthesiologist satisfaction,and patient comfort were recorded.Results There were no significant differences in the time of endoscopic implantation,time of gastroscopy,time of patient awakening and time of patient leaving hospital between the two groups(P>0.05).SBP and DBP in RP group were lower than RE group at T1 and T2(P<0.05).HR at T2 was lower than RE group(P<0.05).SpO2 at T1 was lower than RE group(P<0.05).Compared with T0,CRP Cor and NE levels increased in the two groups at T2,but the increase in DRE group was lower than that in RP group(P<0.05).There was no significant difference in anesthetic effect between the two groups(P>0.05).No serious adverse reactions such as laryngospasm and allergy occurred in the two groups.The incidence of hypotension in DRE group was lower than that in RP group(P<0.05).The incidence of
作者
王建松
王海霞
张杰
崔林
王敏
WANG Jiansong;WANG Haixia;ZHANG Jie;CUI Lin;WANG Min(Department of Anesthesiology,Fourth People's Hospital of Langfang,Langfang 065700,China;Endoscopy Division,Fourth People's Hospital of Langfang,Langfang 065700,China;Clinical Laboratory,Fourth People's Hospital of Langfang,Langfang 065700,China;Department of Pathology,Fourth People's Hospital of Langfang,Langfang 065700,China)
出处
《分子影像学杂志》
2020年第2期325-329,共5页
Journal of Molecular Imaging
基金
廊坊市科学技术研究与发展计划(2019013029)。
