重症老年患者无痛胃肠镜检查麻醉效果研究(1)
摘 要：目的 探索一種以右美托咪定为基础用药用于重症老年患者无痛胃肠镜检查麻醉综合管理方案的有效性和安全性。方法 选择2015年9月～2016年9月于本院就诊的无痛胃肠镜检查老年患者80例，检查前ASAⅡ～Ⅲ级，按心率情况分为A、B两组，每组40例，A组心率80次/min以上，B组心率80次/min以下。根据分组情况分别给予两组患者不同剂量的右美托咪定，观察患者各时间点生命体征、置镜时刺激体动情况、药物用量情况等。结果 两组患者在麻醉诱导完成后，SBP/SpO2与麻醉前相比，差异有统计学意义(P<0.05)；检查前后B组患者的心率均小于A组，差异有统计学意义(P<0.05)；无痛胃镜检查术中、术后情况方面，B组患者置镜时刺激体动情况要好于A组，差异有统计学意义(P<0.05)；B组药物用量少于A组，差异有统计学意义(P<0.05)。结论 综合运用术前住院准备，术中采用专用内镜检查面罩供氧，结合镇静、镇痛、血管活性药物的使用，重症老年患者无痛胃肠镜检查可以安全实施，有利于确保检查顺利完成，临床上应当进一步推广应用。
关键词：老年患者；无痛胃镜；麻醉；依托咪酯；丙泊酚
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中图分类号：R614.2+4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.026
文章编号：1006-1959(2018)08-0084-04
Study on Anesthesia Effect of Painless Gastroenteroscopy in the Elderly Patients with Severe Cases
XU Tian-hua，YE Miao-en，MA Li-jing
(Department of Anesthesiology，Shenzhen Armed Police Hospital，Shenzhen 518029，Guangdong，China)
Abstract：Objective To explore the efficacy and safety of dexmetomide as a basic drug for painless gastroenteroscopy in severe elderly patients.Methods 80 elderly patients who underwent painless gastroscopic examination at our hospital from September 2015 to September 2016 were selected.ASAII～III grades before examination were divided into A and B groups according to heart rate，with 40 cases in each group.The heart rate of group A was 80 beats/min or more and the heart rate of group B was 80 beats/min or less. According to the grouping situation， two groups of patients were given different doses of dexmedetomidine to observe the patient's vital signs at each time point，the stimulation of body movement when the mirror was set， the dosage of the drug and so on.Results After the induction of anesthesia was completed in both groups，there was a statistically significant difference between SBP/SpO2 and pre-anesthesia，the difference was statistically significant(P<0.05)；the heart rate of patients in group B before and after the examination was less than that in group A，the difference was statistically significant(P<0.05)；in the inoperative and postoperative conditions of painless gastroscopy， the stimulating body movement of group B was better than that of group A，and the difference was statistically significant (P<0.05).The amount of drug in the group B was less than that in the group A，and the difference was statistically significant(P<0.05). Conclusion Comprehensive use of preoperative hospital preparation，the use of special endoscopic examination mask oxygen supply， combined with sedative，analgesic，vasoactive drugs use，severe elderly patients with painless gastrointestinal endoscopy can be safely implemented，to ensure the smooth completion of the examination，clinical should be further applied., 百拇医药(许天华 叶妙恩 马立靖)
关键词：老年患者；无痛胃镜；麻醉；依托咪酯；丙泊酚
, http://www.100md.com
中图分类号：R614.2+4 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.08.026
文章编号：1006-1959(2018)08-0084-04
Study on Anesthesia Effect of Painless Gastroenteroscopy in the Elderly Patients with Severe Cases
XU Tian-hua，YE Miao-en，MA Li-jing
(Department of Anesthesiology，Shenzhen Armed Police Hospital，Shenzhen 518029，Guangdong，China)
Abstract：Objective To explore the efficacy and safety of dexmetomide as a basic drug for painless gastroenteroscopy in severe elderly patients.Methods 80 elderly patients who underwent painless gastroscopic examination at our hospital from September 2015 to September 2016 were selected.ASAII～III grades before examination were divided into A and B groups according to heart rate，with 40 cases in each group.The heart rate of group A was 80 beats/min or more and the heart rate of group B was 80 beats/min or less. According to the grouping situation， two groups of patients were given different doses of dexmedetomidine to observe the patient's vital signs at each time point，the stimulation of body movement when the mirror was set， the dosage of the drug and so on.Results After the induction of anesthesia was completed in both groups，there was a statistically significant difference between SBP/SpO2 and pre-anesthesia，the difference was statistically significant(P<0.05)；the heart rate of patients in group B before and after the examination was less than that in group A，the difference was statistically significant(P<0.05)；in the inoperative and postoperative conditions of painless gastroscopy， the stimulating body movement of group B was better than that of group A，and the difference was statistically significant (P<0.05).The amount of drug in the group B was less than that in the group A，and the difference was statistically significant(P<0.05). Conclusion Comprehensive use of preoperative hospital preparation，the use of special endoscopic examination mask oxygen supply， combined with sedative，analgesic，vasoactive drugs use，severe elderly patients with painless gastrointestinal endoscopy can be safely implemented，to ensure the smooth completion of the examination，clinical should be further applied., 百拇医药(许天华 叶妙恩 马立靖)