不同年龄段成年人群实施结肠镜检查的镇静特点  

Influence of age on sedation for colonoscopy in adults

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

机构地区：[1]中南大学湘雅三医院消化内科,长沙410013

出　　处：《中南大学学报（医学版）》2011年第2期165-169,共5页Journal of Central South University ：Medical Science

基　　金：湖南省卫生厅科研基金(B2009-047)~~

摘　　要：目的：探讨不同年龄段成年人群中实施镇静性结肠镜检查时的镇静特点,为临床合理用药提供参考。方法：收集180例接受镇静性结肠镜检查的患者,分为青年组（n=45,18~44岁）、壮年组（n=78,45~64岁）,老年组（n=57,65~80岁）。术前均给予咪唑安定0.02~0.03 mg/kg,异丙酚0.5~2.5 mg/kg,术中酌情追加异丙酚用量。结果：青年组及壮年组咪唑安定剂量、异丙酚用量（初始剂量及总剂量）明显多于老年组（P〈0.01）;从操作者角度评估,老年组镇静质量显著高于其他2组;3组血压均有显著影响,3组血压、心率、氧饱和度、严重不良事件发生率比较差异无统计学意义（P〉0.05）。结论：在实施镇静性结肠镜检查时,适当加大青年人群咪唑安定和异丙酚用量可使肠镜检查更顺利;老年人群结肠镜检查时镇静质量较好,可适当减少咪唑安定和异丙酚用量。Objective To investigate the efficacy and risk of midazolam and propofol for sedation during colonoscopy procedures in adults of different age groups.Methods A total of 180 patients undergoing colonoscopy were allocated to 3 groups： a young adult group（n=45,18-44 years）,a mid-aged group（n=78,45-64 years） and an elderly group（n=57,65-80 years）.All patients were premedicated with midazolam 0.02-0.03 mg/kg and propofol 0.5-2.5 mg/kg.The pulse rate,arterial pressure,and oxygen saturation for each patient were monitored continuously before,during and after the procedure.Results The doses of midazolam and propofol for the young adults were significantly higher than that for the mid-aged and the eldery（P0.01）.Based on the view of gastroenterologists,the satisfied rate of sedation quality was significantly higher in the elderly group than that in the young or the mid-aged group（P0.01）.There were significant changes in the arterial pressure in all groups compared with the baseline level（P0.01）,but there was no significant difference among the 3 groups.Other parameters such as heart rate,saturation of O2,and the rate of severe adverse reaction among the 3 groups were not significantly different（P0.05）.Conclusion Higher dose of midazolam and propofol is needed to obtain the sedation quality in young adults.Whereas for the elderly,properly reducing the dose of midazolam and propofol may still keep the sedation quality during colonoscopy procedures.

关 键 词：年龄 结肠镜检查 咪唑安定 异丙酚 镇静麻醉 

分 类 号：R574.6[医药卫生—消化系统]