自控镇痛技术在双气囊内镜检查中的可行性和安全性研究  

Feasibility and safety of patient controlled analgesia technology in double-balloon endoscopy

作　　者：万革[1] 郭强[1] 何甜[1] 岳伟[1] 罗静[2] 金华[2] 王骊[1] 赵琳[1] 

机构地区：[1]云南省第一人民医院消化科,昆明650032 [2]云南省第一人民医院麻醉科,昆明650032

出　　处：《中华胃肠外科杂志》2012年第7期694-696,共3页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价患者自控镇痛（PCA）技术在双气囊内镜（DBE）检查过程中的安全性和可行性。方法根据麻醉方式的不同．前瞻性将2007年5月至2011年5月间云南省第一人民医院收治的120例疑似小肠疾病的患者按随机数字表法随机分为未行麻醉处理（A组）、TCI静脉泵输注丙泊酚（B组）和PCA泵静脉输注瑞芬太尼（c组）3组，每组40例。比较3种麻醉方法应用于DBE检查的可行性和安全性价。结果B组和C组患者耐受性较好，操作成功率均为100％。明显优于A组的80％（12／40，P〈0．01）。A组和B组患者血压、心率和血氧饱和度在操作过程中波动较大，而C组患者则较为平稳。B组和C组患者的病变检出率分别为67．5％（27／40）和72．5％（29／40）。明显高于A组的37．5％（15／40．均P〈0．01）。C组与B组比较，内镜到达深度更远，操作结束后离院时间更短（均P〈0．05）。结论PCA技术应用于DBE检查中．可满足患者在不同时刻的个体化镇痛需要，提高患者对检查的耐受性及依从性．能与操作者进行交流及配合变换体位．降低操作风险．提高双气囊内镜的操作成功率。Objective To evaluate the feasibility and safety of patient controlled analgesia （PCA） technology during double balloon endoscopy （DBE） inspection. Methods According to the anesthesia, 120 patients with suspected intestinal disease were randomized into non-anaesthesia（Group A）, propofol infusion with TCI vein pump （Group B）, and remifentanil vein infusion with PCA pump （Group C）, with 40 patients in each group. The feasibility and safety of the three methods in double balloon endoscopy （DBE） inspection were evaluated. Results The tolerance in groups B and C was good and the procedure success rate was 100%, significantly higher than Group A （80%, 12/40, P〈 0.01 ）. The fluctuation of blood pressure, heart rate, and oxygen saturation was significantly greater in groups A and B, while patients in Group C remained stable. The detection rate was 67.5%（27/40） in Group B and 72.5%（29/40） in Group C, significantly higher than that in Group A（37.5%, 15/40, all P〈0.01）. The depth of endoscope was longer and the length of hospital stay shorter in Group C as compared to Group B （both P〈0.05）. Conclusion The application of PCA technology in the doubleballoon endoscopy inspection can meet the individualized analgesic needs of patients in different period, increase the tolerance and compliance of patients to the inspection, facilitate patient-operator communication and positions change, reduce the operation risk, and increase the success rate of double balloon endoscopy.

关 键 词：双气囊内镜 麻醉 患者自控镇痛 瑞芬太尼 

分 类 号：R473.6[医药卫生—护理学]