无痛胃肠镜检查在保健工作中的开展及最佳麻醉方案的探讨  

Exploration of the optimistic anesthetics for gastroscopy and intestinoscopy

作　　者：郭英[1] 王爱国[1] 刘培中[1] 宋运琴[1] 张宏[1] 

机构地区：[1]解放军总医院麻醉手术中心,北京100853

出　　处：《中华保健医学杂志》2008年第3期186-188,共3页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨无痛胃肠镜检查在保健工作中的开展及可采用的最佳麻醉方法、麻醉用药。方法回顾性分析1997～2007年间保健工作中无痛胃肠镜开展情况及检查者所采用的麻醉方法、麻醉用药及不良反应。结果1997～2007年行消化道无痛胃肠镜检查者共805例,被检查者数量逐年增加,尤以2005年以后增加明显(2005年46人次;2006年196人次;2007年520人次),2005年以前胃肠镜检查分开进行,2005年以后除了复查性检查外,胃肠镜检查多一次完成。麻醉方法及用药:2005年以前神经安定镇痛麻醉(咪唑安定1mg+芬太尼50μg或可塞风8mg或凯芬50mg),2005年以后全静脉麻醉(咪唑安定1mg+芬太尼50μg或氯诺昔康(可塞风)8mg或氟比洛芬酯(凯芬)50mg+丙泊酚(异丙酚)0.8～1.2mg/kg),所有检查者无1例发生麻醉意外或并发症。结论在以60岁以上老年人为主的保健对象中,采用神经安定镇痛麻醉和全静脉麻醉方法行无痛胃肠镜检查安全、可行,应强调个体化给药方案。Objective To explore the optimistic anesthetic technique and drugs during the endoscopy of gastrointestinal tract. Methods Review of the methods of anesthesia,anesthetic drugs and complications during the period of 1997-2007. Results The total number of gastroseopy and eolonoscopy with anesthesia is 805 cases. The number was increasing quickly,especially after 2005, for example 2005：46 cases,2006：193 cases,2007：520 cases. Gastroseopy and eolonoseopy were separetaly operated before 2005, and afterall both were operated one time. Anesthetic technique and drugs： sedation and analgesia before 2005： midazolam Img＋fentanil 50ug or lornoxieam 8mg（flurbiprofen axetil 50mg）,total intravenous anesthesia after 2005： midazolam Img＋fentanil 50 p,g or lomoxieam 8 mg（flurbiprofen axetil 50 mg）＋propofol 0.8-1.2 mg/kg,there was no anesthetic complication or accident in the gastroseopy and eolonoseopy. Conclusions For the elderly people of over 60- years- old in the health care,sedation and total intravenous anesthesia are safe and feasible for gastroseopy and eolonoscopy, but it is necessary to emphasize anesthesia individually.

关 键 词：消化道 内窥镜 麻醉 

分 类 号：R573[医药卫生—消化系统] R574.62[医药卫生—内科学]