内镜下逆行胰胆管造影高血压患者的麻醉方案研究  

Research on anesthesia under endoscopic retrograde cholangiopancreatography for patients with hypertension

作　　者：彭蔚[1] 肖亮灿[1] 许静红[1] 杜佳楠[1] 喻学海[1] 

机构地区：[1]海南省农垦三亚医院麻醉科,海南三亚572000

出　　处：《中国内镜杂志》2015年第3期251-254,共4页China Journal of Endoscopy

基　　金：广东省科委基金(No:2010B031600045)

摘　　要：目的 了解内镜下逆行胰胆管造影术（ERCP）高血压患者的不同麻醉方案效果。方法 选择ASAⅡ、Ⅲ级,年龄50～70岁的择期行ERCP的患者120例,随机分为3组,右美托咪定组（A组）;丙泊酚组（B组）及咪达唑仑组（C组）,每组40例。观察和记录给药前、给药后1 min、内镜插入食管、停药及苏醒期5个时点的收缩压（SBP）、舒张压（DBP）、心率（HR）和动脉血氧饱和度（SPO2）的变化,并观察其不良反应的发生情况。结果 A组用药后各时间点的观察指标波动最小,且不良反应发生率最低。结论 右美托咪定复合芬太尼用于高血压患者ERCP安全可靠,是一种目前较为理想的麻醉方法。【Objective】 To select the most suitable aneasthesia for endoscopic retrograde pancreatic angiography（ERCP） in patients with high blood pressure. 【Methods】ASA Ⅱ ~ Ⅲ level, aged 50 to 70 of 120 patients with marked line of ERCP were randomly divided into 3 groups： dexmedetomidine group（group A）; propofol group（group B） and midazolam group（group C）, with 40 cases in each group. The systolic blood pressure（SBP）,diastolic blood pressure（DBP）,heart rate（HR） and pulse oxygen saturation（Sp O2） changed were observed and recorded before dosing, 1 minute after treatment, endoscope insertion into the esophagus, with drawl, and waking up.The adverse reactions were observed at the same time. 【Results】In group A, at each time point the observed index fluctuation was the least and the incidence of adverse reaction was minimum. 【Conclusion】 Dexmedetomidine combined with fentanyl is safe and reliable in patients with high blood pressure, which is a kind of ideal aneathesia method at present.

关 键 词：右美托咪定 芬太尼 静脉麻醉 高血压患者 ERCP 

分 类 号：R614.2[医药卫生—麻醉学]