异丙酚的不同用法在镇静性上消化道内镜术中的效果  

Effect of various uses of propofol on theupper gastrointestinal endoscopy

作　　者：肖定华[1] 沈守荣[1] 徐灿霞[1] 唐五良[1] 王晓艳[1] 王芬[1] 

机构地区：[1]中南大学湘雅三医院消化科,长沙410013

出　　处：《中南大学学报（医学版）》2007年第3期443-446,共4页Journal of Central South University ：Medical Science

基　　金：湖南省社会发展科技项目(02ssy3081)~~

摘　　要：目的:研究异丙酚的不同用法对镇静性上消化道内镜术安全性的影响。方法:400例行镇静性上消化道内镜术的患者按来院检查时间的先后顺序分成A,B,C,D共4组(均n=100),观察咪唑安定与异丙酚注药之间的不同间隔时间(A和D组为30s^1min,B和C组为3~5min)及异丙酚的不同注药速度(A和B组为16~25mg/10s,C和D组为6~7mg/10s)对异丙酚用量及清醒时间的影响。结果:在一定范围内应用咪唑安定后再用异丙酚的间隔时间较长者,异丙酚用量较小;异丙酚推注速度较慢者,用量亦可减少,A,B,C,D组异丙酚用量分别为(111.90±22.43),(102.20±15.99),(73.05±13.08)和(80.90±17.36)mg,4组间比较差异均有统计学意义(均P<0.01);用量较小组(C,D组)受检者清醒时间亦相对缩短,A和B组的清醒时间分别为(14±5),(13±3)min,C和D组分别为(9±1),(10±2)min,A,B组与C,D组比较差异有统计学意义(均P<0.01)。结论:在一定范围内严格控制异丙酚的注药速度及咪唑安定与异丙酚的给药间隔时间,可相应减少异丙酚的用量,缩短清醒时间,从而使镇静性上消化道内镜术的应用更安全。Objective To investigate the efficacy and security of different uses of propofol on the sedation during the upper gastrointestinal endoscopic procedures. Methods Four hundred patients who underwent gastroscopy received midazolam and propofol as sedation. Patients were divided to 4 groups with different intervals between midazolam and propofol ： Group A and D with the interval of 30 seconds to 1 minute, Group B and C with 3 to 5 minute interval. All patients were premedicated with midazolam and propofol at 16～25 mg/10s （Group A and B） and 6～7 mg/10 s （Group C and D）. Results The doses of propofol of Group A,B,C, and D were （111.90 ±22.43）, （102.20 ±15.99）,（73.05±13.08） and （80.90 ±17.36） mg respectively, with significant difference （ P 〈 0.01 ）. The time of return to consciousness decreased markedly in Group C and D [ （9±1）, （10 ±2） mini, and that of Group A and B was [ （14 ±5）, （13 ±3） mini. There was significant difference between Group C, D and Group A, B （ P 〈 0.01 ）. Conclusion The dose of propofol and the time of return to consciousness depend on the rate of administration and the interval between midazolam and propofol. Appropriate rate and interval can produce safer and more effective sedation for the upper gastrointestinal endoscopic procedure.

关 键 词：异丙酚 咪唑安定 镇静 消化道内镜术 

分 类 号：R57[医药卫生—消化系统]