无痛与普通胃镜的对比研究  

A Contrast Research of Painless and Ordinary Endoscopy Examination

作　　者：王炳周[1] 吴灵飞[1] 杜瑞明[1] 谢静玲[1] 

机构地区：[1]汕头大学医学院第二附属医院

出　　处：《内蒙古中医药》2009年第3期1-4,共4页Inner Mongolia Journal of Traditional Chinese Medicine

摘　　要：目的：探讨异丙酚联合芬太尼、咪唑安定、盐酸阿扎司琼用于无痛内镜检查的安全性及其优缺点。方法：80例胃镜检查,30例自愿进行无痛胃镜检查,术前先静注芬太尼0.05mg、咪唑安定2～3mg、盐酸阿扎司琼10mg,然后缓慢静推异丙酚直至睫毛反射消失再进镜检查。对照组50例按常规胃镜检查,术前含服盐酸利多卡因胶浆。记录两组检查前、检查中、检查后10分钟的心率、血压、血氧饱和度、对胃镜检查的痛苦回忆及无痛组的用药情况等资料,比较两组的优缺点及评价无痛内镜的安全性。结果：30例常规胃镜检查过程心率、血压升高,差别有高度统计学意义（P〈0.01）,血氧饱和度无明显变化,88%有明显痛苦回忆,表示不愿再进行胃镜检查。无痛组静推异丙酚后心率、血压下降,差别有高度统计学意义（P〈0.01）,血氧饱和度在连续吸氧情况下变化不明显,所有病人均于开始检查后6分钟内苏醒并切题对答,均无胃镜检查的痛苦回忆,100%表示必要时愿再行胃镜检查。结论：异丙酚联合芬太尼、咪唑安定、盐酸阿扎司琼应用于无痛胃镜检查可控性强,异丙酚用量少,麻醉安全有效,患者舒适无痛苦。上述药物联合适合于门诊患者无痛胃镜检查,值得大力推广。Objective： To explore the safety and efficacy of propofol combined with azasetron , midazolam and fentanyl use in gastroscopy. Methods： 80 patients were divided into two groups. Group 1 （30 patients） were volunteers for painless gastroscopy examination and were given intravenous fentany, azasetron, and midazolam, And then propofol was slowly injected to the patients until their eyelash stopping reflex. Finally gastroscope examination was preceded. Patient＇s feeling and discomfort were compared to those for the 50 patients without sedation （control group）. The changes of blood pressure, heart rate and blood oxygen saturation were recorded and analyzed. Results： The blood pressures and the heart rates in sedative group were decreased during the procedure（p〈0.01）, and were recovered after gastroscopy. All patients did not have discomfort memories. While the blood pressure and the heart rate in control group were increased during the procedure（p〈0.01）. Forty--four patients （88%） had discomfort memories. However the blood oxygen saturation had no change in two groups（p〉0.05）. Conclusion： The application of propofol in conjunction with azasetron, fentanyl,midazolam in painless gastroscopy is highly safe and effective.

关 键 词：异丙酚 芬太尼 咪唑安定 盐酸阿扎司琼 无痛胃镜检查 

分 类 号：R573[医药卫生—消化系统]