一种新的低氧易感人群胃镜检查无痛术——分步给药镇静法  

Two-stage administration sedation method for gastroscopy in hypoxia predisposed patients

作　　者：王晓艳[1] 王芬[1] 肖定华[1] 沈守荣[1] 

机构地区：[1]中南大学湘雅三医院消化内科,长沙410013

出　　处：《中南大学学报（医学版）》2005年第3期331-334,共4页Journal of Central South University ：Medical Science

基　　金：卫生部第二轮十年百项计划推广项目(031101);湖南省社会发展科技项目(02SSy3081)

摘　　要：目的:探讨分步给药镇静法在低氧易感人群胃镜检查中的安全性和镇静/镇痛效果。方法:将接受胃镜检查的64例有鼾症或咳痰的患者随机分为2组,分别采用常规序贯给药镇静法和分步给药镇静法对患者实施胃镜检查前的镇静/镇痛术,分析2种镇静法对收缩压(SBP)、舒张压(DBP)、血氧饱和度(SpO2)、镇静深度、进镜时咽部不适程度、清醒时间、异丙酚用量和对胃镜检查过程及不适的遗忘程度的影响,评价2种方法在低氧易感人群胃镜检查中的安全性和镇静/镇痛效果。结果:无痛胃镜采用分步给药法的患者镇静深度(OAA/S评分2级)较常规序贯给药法患者的镇静深度(OAA/S评分1级)浅(P<0.01),清醒时间短(P<0.01),异丙酚用量少(P<0.01),但进镜时咽部不适反应较序贯给药法明显(P<0.01)。分步给药法对血氧饱和度(SpO2)的影响较序贯给药法小(P<0.01),呼吸抑制程度轻,安全性好。分步给药法组对胃镜检查过程的遗忘程度低于序贯给药法组(P<0.01),但对胃镜检查不适的遗忘程度及收缩压(SBP)和舒张压(DBP)的影响与常规序贯给药法无明显差别(P>0.05)。结论:分步给药镇静法是一种适用于低氧易感人群无痛胃镜检查的安全、有效的镇静/镇痛方法。Objective To explore the safety and the efficacy of two-stage administration sedation method (with propofol plus midazolam) in the analgesia gastroscopy for hypoxia predisposed patients. Methods Sixty-four hypoxia predisposed patients (with snore or expectoration) were divided into two groups and received sedation respectively with two-stage administration method and routine continuum administration method before gastroscopy. We analyzed the alteration of SBP, DBP, SpO 2 , sedation level, the degree of pharyngeal malaise, recovery time, dose of propofol,the lethe degree of upset, and procedure of gastroscopy to evaluate the safety and the efficacy of the two methods in the analgesia gastroscopy for hypoxia predisposed patients. Results Compared with routine continuum administration sedation method,two-stage administration sedation method had little influence on SpO 2 ,so it reduced the accident of respiratory arrest (P<0.01). The gastroscopy could be achieved at the lower sedation level with two stage administration method (P<0.01), so that the recovery time was shortened (P<0.01). The degree of pharyngeal malaise in the patients with two-stage administration sedation method was higher than that of patients with routine continuum administrationsedation method (P<0.01), and the dose of propofol used for sedation decreased (P<0.01). While the lethe degree of gastroscopy upset and alteration of SBP,DBP were rated similarly in both groups (P>0.05), and the lethe degree of gastroscopy procedure in two-stage administration method group was significantly lower than that of routine continuum administration method group (P<0.01). Conclusion The two-stage administration sedation method is a new effective and safe sedation method for gastroscopy in the hypoxia predisposed patients.

关 键 词：分步给药镇静法 低氧易感人群 无痛胃镜 

分 类 号：R573[医药卫生—消化系统]