高血压患者无痛肠镜与普通肠镜检查临床分析  

The clinical study of propofol combined with fentanl in hypertensive patients undergoing colonoscopy

作　　者：邱敏[1] 李森娟[1] 方芬[1] 曹晨曦[1] 陆其明[1] 

机构地区：[1]浙江省嘉兴市第二医院肛肠科,浙江嘉兴314000

出　　处：《中国内镜杂志》2013年第4期402-405,共4页China Journal of Endoscopy

摘　　要：目的探讨高血压患者无痛肠镜检查的安全性、可行性。方法 300例高血压患者随机分为常规肠镜组(A组,n=150)和无痛肠镜组(B组,n=150)。A组按常规方法进行肠镜检查,B组由静脉缓注芬太尼0.5～1.0mg/kg,丙泊酚0.5～2.0mg/kg,在检查观察中分在检查前、刚进镜时、达回盲部时及检查完成时观察MAP、HR、RR、SPO2的变化。结果 A组在达回盲部、检查完成时的MAP、HR较检查前明显上升(P<0.01);B组的MAP、HR在麻醉成功后开始下降(P<0.01),而在进镜过程中MAP、HR与RR的变化无明显差异。与A组相比,B组的各观察点的MAP、HR和RR有明显下降(P<0.01),两组患者的SPO2无显著差异。两组患者在完成时间上无明显差异,而B组的成功率显著高于A组(P<0.01)。在不良反应发生情况中,A组的腹胀、腹痛及肢体扭动的发生率高(P<0.01),而B组的恶心呕吐、头晕及心动过缓的发生率较高(P<0.01)。结论无痛肠镜检查对高血压患者是安全、可行的。[Objective] To evaluate the safety,validity and feasibility of hypertensive patients undergoing analgesia colonoscopy.[Method] 300 hypertensive patients accepted colonoscopy were randomly divided into group A （n=150） and group B （n=150）.Patients in group A received routine treatment and the group B accepted analgesia colonoscopy.During the examination the propofol （1.5-2.0 mg/kg） and remifetanil （0.5g-1.0mg/kg） was used in group B.Colonoscopy inserting began when patient＇s lids relax dully,stopped infusion when colonoscopy reached ileocecal region.The changes of mean artery pressure,heart rate,respiratory rate and blood oxygen saturation were recorded and analyzed during operation and after operation.[Result] Compared with the before operation,the mean artery pressure and heart rate are upgrade obviously in group A （P 0.01）,but which were downgrade after succession of anesthesia in group B （P 0.01）.There were no significant changes of MAP,RR,HR during the whole colonoscopy inserting process.Compared with the group A,the MAP,HR,RR were obviously downgrade in group B at each observation spot （P 0.01）,however,there was no significant difference about SPO2,operation time in two group.The success rate of operation in group B was higher than group A obviously （P 0.01）.About adverse reaction,the incidence rate of abdominal pain,abdominal distension and body movement in group A was higher than group B （P 0.01）,but,the nausea,vomiting,dizziness,bradycardia in group B was more common （P 0.01）.Successful rate of colonoscopy in group B （98.7%） was higher than that in group A （92%）,however,the operation time of colonoscopy was no significant difference in two groups.During colonoscopy operation adverse effect in group A was lower than that of the norm al group and the group A patients were more comfortable.[Conclusion] Analgesia colonoscopy is applicable and safe in hypertension patients.

关 键 词：高血压 结肠镜检查 丙泊酚 芬太尼 

分 类 号：R544.1[医药卫生—心血管疾病]