病人自控镇痛技术在结肠镜检查中的临床应用  

Application of Patient Controlled-analgesia in Colonoscopy

作　　者：金华[1,2] 宁杰[1,2] 李江[1,2] 朱丽璇[1,2] 潘卫州[1,2] 李艳华[1,2] 

机构地区：[1]云南省第一人民医院 [2]昆明医学院昆华附属医院麻醉科,云南昆明650032

出　　处：《昆明医学院学报》2011年第9期38-41,45,共5页Journal of Kunming Medical College

基　　金：云南省应用基础研究计划基金资助项目(2008ZC082M)

摘　　要：目的对比研究病人自控镇痛(PCA)技术应用于结肠镜检查的安全性和有效性.方法 120例ASAⅠ-Ⅱ级行结肠镜检查患者分为对照组(C组)、异丙酚组(P组)和PCA泵输注组(PCA组),每组40例.C组未行麻醉处理;P组静脉注射异丙酚1.5～2 mg/kg即开始镜检;PCA组以PCA泵静脉输注瑞芬太尼维持镇痛效果.记录镇痛效果、镜检情况、生命体征、不良反应等,进行统计分析.结果 P组和PCA组镇痛效果明显优于C组(Ρ<0.01),且镜检成功率及患者满意度高于C组(Ρ<0.01);P组不能主动翻身配合检查,镜检开始及检查中血压下降、呼吸抑制较另两组明显(Ρ<0.01),患者留院时间较长;PCA组检查者满意度较另两组高(Ρ<0.05),不良体动反应少见(Ρ<0.01).结论 PCA技术用于结肠镜检查镇痛效果完善,安全性好,病人检查中能主动配合医生变换体位,使肠镜操作流程更加顺畅,值得临床推广应用.Objective To evaluate the safety and feasibility of patient controlled-analgesia（PCA）used in colonoscopy.Methods 120 patients with ASA Ⅰ～Ⅱundergoing colonoscopy were randomly divided into three groups：group C,group P and group PCA.In group C（n=40）,no anaesthetic was used.In group P（n=40）,1.5～2.0 mg/kg propofol was slowly injected intravenously.In group PCA（n=40）,remifentanil was injected by PCA system.The antalgic effect,colonoscopy result,vital signs,and adverse reactions were recorded and compared among three groups.Results In group P and group PCA,the antalgic effect was better than group C（P0.01）,and success rate and satisfaction of the patients were higher（P0.01）.In group P,patients could not cooperate,MAP decreased than the other groups（P0.01）,hypopnea was more frequent（P0.01）,and total length of hospitalization was longer（P0.01）.In group PCA,satisfaction of the operator was higher than the other groups（P0.05）,ill-movements were less（P0.01）.Conclusion PCA in colonoscopy is safe and effective in analgesia,and can make patients actively cooperate to doctors to achieve successful colonoscopy,therefore deserves generalizing in clinic.

关 键 词：病人自控镇痛 瑞芬太尼 异丙酚 结肠镜 

分 类 号：R614.25[医药卫生—麻醉学]