摘要
目的观察西藏高原地区行无痛苦胃镜患者检查过程中不良反应发生情况,分析主要不良反应发生的危险因素。方法 810例消化道不适患者,静脉缓慢注射芬太尼1μg/kg、丙泊酚2 mg/kg麻醉后行无痛苦胃镜检査,记录不良反应发生情况,采用多因素logistic回归分析主要不良反应发生的危险因素。结果检查中血氧饱和度(blood oxygen saturation,SpO_2)水平[(90.20±0.33)%]低于检査前[(98.30±0.52)%](P<0.05),检査后恢复至检査前水平;检査前、中、后平均动脉压(mean arterial pressure,MAP)[(93.80±10.20)、(87.30±8.50)、(91.60±9.60)mm Hg]、心率[(72.80±13.60)、(66.60±11.80)、(71.20±12.70)次/min]、呼吸频率[(18.50±4.60),(16.90±3.90)、(17.80±4.20)次/min]比较差异均无统计学意义(P>0.05);检查中发生低氧血症59例(7.3%),一过性呼吸抑制12例(1.5%),呛咳2例(0.2%),头晕3例(0.4%);多因素logistic回归分析结果显示,吸烟≥10根/d且烟龄>20 a(OR=4.36,95%CI:2.168~8.779,P=0.000)、饮酒≥40 g/d且饮酒史>10 a(OR=11.95,95%CI:5.174~27.602,P=0.000)、体质量指数≥30 kg/m^2(OR=10.04,95%CI;5.439~18.522,P=0.000)、丙泊酚用量≥160 mg(OR=2.70,95%CI:1.560~4.679,P=0.000)是检査中发生低氧血症的危险因素。结论西藏高原地区行无痛苦胃镜患者检査过程中最主要的不良反应为低氧血症,吸烟≥10根/d且烟龄>20 a、饮酒≥40 g/d且饮酒史>10 a、体质量指数≥30 kg/m^2、丙泊酚用量≥160 mg是其发生的危险因素。
Objective To observe the adverse reactions of painless gastroscopy in Tibet plateau,and analyze the risk factors for major adverse reactions.Methods A total of 810 patients with gastrointestinal disorders received painless gastroscopy after anesthesia by intravenous injection of fentanyl 1μg/kg and propofol 2 mg/kg.The adverse reactions of painless gastroscopy were recorded,and multivariate logistic regression was used to analyze the risk factors for major adverse events.Results The mean blood oxygen saturation during gastroscopy((90.20±0.33)%) was significantly lower than that before gastroscopy((98.30±0.52)%)(P<0.05),and returned normal after gastroscopy.There were no significant differences in the mean arterial pressure((93.80±10.20),(87.30±8.50),(91.60±9.60) mm Hg),heart rate((72.80±13.60),(66.60±11.80),(71.20±12.70) beat/min),and respiration rate((18.50±4.60),(16.90±3.90),(17.80±4.20) time/min) before,during and after painless gastroscopy(P> 0.05).The adverse reactions included hypoxemia in 59 patients(7.3%),transient respiratory depression in 12(1.5%),choking cough in 2(0.2%),and dizziness in 3(0.4%).Multivariate logistic regression analysis showed smoking history >20 years with average daily smoking ≥10 cigarettes(OR = 4.36,95%CI:2.168-8.779,P = 0.000),drinking history > 10 years with average daily drinking≥40 g(OR = 11.95,95%CI:5.174-27.602,P= 0.000),body mass index ≥30 kg/m^2(OR =10.04,95%CI:5.439-18.522,P=0.000) and propofol dosage ≥160 mg(OR =2.70,95%CI:1.560-4.679,P =0.000) were the major risk factors for hypoxemia.Conclusion Hypoxemia is the major adverse reaction of painless gastroscopy in Tibet plateau.The smoking history > 20 years with average daily smoking ≥10 cigarettes,the drinking history >10 years with average daily drinking ≥40 g,body mass index ≥30 kg/m^2 and propofol dosage ≥160 mg are the major risk factors for hypoxemia.
出处
《中华实用诊断与治疗杂志》
2017年第3期248-250,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
武警后勤学院附属医院种子基金(FYM201531)
关键词
消化道疾病
无痛苦胃镜
西藏地区
不良反应
危险因素
Gastrointestinal disease
painless gastroscopy
Tibet plateau
adverse reactions
risk factors
