无痛肠镜检查在门诊老年人群中应用的临床分析  

Painless management in outpatient old population during fibroenteroscopy.

作　　者：万永灵[1] 周木香[2] 李祥奎[2] 许婷[2] 齐国华[2] 

机构地区：[1]四川大学华西医学中心 [2]四川省人民医院,四川成都610072

出　　处：《四川医学》2006年第2期135-136,共2页Sichuan Medical Journal

摘　　要：目的探讨3种无痛措施在门诊老年纤维结肠镜检查中的应用价值。方法选择300例门诊纤维结肠镜检查的老年患者,随机分为A、B、C 3组,A组采用异丙酚加少量芬太尼,B组用异丙酚,C组选异丙酚加少量咪唑安定作无痛处理,观察每组病例检查前、中、后NIBP、ECG、HR、SpO2%,同时观察各组检查时间、异丙酚用量、呼吸抑制,梦幻发生以及苏醒及滞留时间。结果3组病人在检查过程中血压均有明显下降,心率也减慢,单用异丙酚时更明显,但苏醒较快,滞留时间短;所有病例均顺利完成检查,检查时间长短无差别;当加用芬太尼或咪唑安定时,异丙酚用量可减少,但苏醒稍慢、滞留观察时间延长。结论异丙酚复合少量芬太尼,单用异丙酚以及异丙酚复合少量咪唑安定均能满足老年患者门诊无痛纤维结肠镜检查的要求,同时检查中加强对生命体征的监测也必不可少。Objective To investigate the results of three formula of painless management in outpatient old population during fibroenteroscopy. Methods Three hundred outpatient old population, scheduled to undergo painless fibroenteroscopy, were randomly divided into three groups.Propofol combined with low-dose fentanyl was administered in Group A,propofol only in Group B and propofol with low-dose midazolam was given in Group C. NIBP,ECG, HB, SpO2% were recorded before fibroenteroscopy, also during and after fibroenteroscopy. Length of fibroenteroscopy time, total propofol dosage, respiratory inhibition, dream and hallucination, recovery time and stay time were also recorded. Results Blood pressure decreased significantly in all patients, HR declined slighty, especially in Group B. There is no difference about length of fibroenteroscopy time. When fentsnyl administered （ Group A） or midazolam added （ Group C）, lower propofol usage was recorded,recovery time and stay time might be longer than these in Group B.Conclusion It is satisfactory in outpatient old population to administer propofol combined with fentanyl, propofol only, also propofol with midazolam during fibroentcroscopy. It is also important to monitor the patients＇ vital signs duriy fibroenteroscopy.

关 键 词：老年人 异丙酚 纤雏结肠镜 无痛处理 

分 类 号：R574[医药卫生—消化系统]