镇静性上消化道内镜术在鼾症患者中的应用  

Efficacy and security of sedation in upper gastrointestinal endoscopy in snoring patients

作　　者：肖定华[1] 王芬[1] 王晓艳[1] 唐五良[1] 杨慧[2] 沈守荣[1] 

机构地区：[1]中南大学湘雅三医院消化科,长沙410013 [2]中南大学湘雅三医院麻醉科,长沙410013

出　　处：《中南大学学报（医学版）》2010年第11期1174-1177,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:对比鼾症患者接受镇静性上消化道内镜术时的不同给药方法,使该技术在此类患者中的应用更安全、有效。方法:将ASAI-II级拟接受镇静性上消化道内镜术的患者1117例分成A组、B组、C组,每组分别施以不同的方法,观察各组异丙酚用量,术中反应,术前、术中、术后SPO2变化,严重呼吸抑制的发生率;由操作者评估每组的镇静质量。结果:A组术中一过性SPO2下降率(50.4%)明显高于B组(3.1%)及C组(18.5%)。异丙酚用量A组、B组、C组分别为(108.5±18.02),(57.50±7.50),(79.8±10.02)mg,组间比较差异均有统计学意义(P<0.05)。严重呼吸抑制发生率A组(1.2%)明显高于B组(0%)及C(0%)组。镇静质量A组、C组满意率均为100%,B组满意率为74%,与A组和C组比较,差异有统计学意义(P<0.05)。结论:在给鼾症患者实施镇静性上消化道内镜术时,采取异丙酚分步静脉给药法或异丙酚一次性缓慢静脉给药法均能有效减少鼾症患者接受镇静性上消化道内镜术时呼吸抑制的发生率,且患者对检查过程无记忆,均不失为安全、有效的方法。Objective To investigate the efficacy and security of different administrations of propofol on the sedation in upper gastrointestinal endoscopic procedures in snoring patients. Methods A total of 1 117 patients with snoring in ASA I-II level,who underwent gastroscopy and received propofol as sedation,were assigned to Group A,Group B,and Gourp C. These groups had different administration methods of propofol. The dose of propofol,response to endoscopic procedures,changes of oxygen saturation of arterial blood （ SPO2 ） ,incidence of severe respiratory depression and sedation quality assessed by operators were observed. Results The incidence of transient decline in SPO2 in Group A,B,and C were 50. 4% ,3. 1% ,and 18. 5% ,respectively. The doses of propofol of Group A,B,and C were（ 108. 50 ± 18. 02） mg,（ 57. 50 ± 7. 50 ） mg,and （ 79. 80 ± 10. 02 ） mg,respectively,with significant difference（ P 0. 05） . The incidence of severe respiratory depression in Group A was 1. 2% ,but Group B and C were 0% . Compared with Group A（ 100% ） and C（ 100% ） ,the satisfaction rate of sedation quality in Group B was 74% ,with significant difference （ P 0. 05） . Conclusion During the upper gastrointestinal endoscopic procedures,snoring patients are premedicated with propofol in various uses by steps or one slow administration. Both methods are safe and effective to reduce the incidence of severe respiratory depression,and patients have no memory of the procedure.

关 键 词：镇静 上消化道内镜 鼾症 

分 类 号：R766[医药卫生—耳鼻咽喉科]