依托咪酯脂肪乳联合丙泊酚在舒适胃镜+结肠镜检查中的应用  

Etomidate Fat Emulsion Combined with Propofol Used in Comfortable Gastroscopy and Colonoscopy

作　　者：刘振明 丁蒙 将谋珅 

机构地区：[1]张家港广和中西医结合医院麻醉科,江苏张家港215633

出　　处：《湖北民族学院学报（医学版）》2016年第3期30-32,共3页Journal of Hubei Minzu University(Medical Edition)

摘　　要：目的观察依托咪酯脂肪乳联合丙泊酚在患者舒适胃镜＋结肠镜中应用效果及可行性。方法 ASAⅠ~Ⅲ级自愿行舒适胃镜＋结肠镜检查的住院患者180例,依据麻醉用药方式将其分为丙泊酚组（A组）,依托咪酯脂肪乳组（B组）,依托咪酯脂肪乳联合丙泊酚组（C组）三组,每组60例。三组均先静脉缓慢推注芬太尼0.5~1.0 mg,1min后A组静脉注射丙泊酚1.5~2.0 mg/kg,B组静脉注射依托咪酯脂肪乳0.3 mg/kg,C组先静脉注射丙泊酚0.5~0.8 mg/kg再注入依托咪酯0.15 mg/kg,睫毛反射消失时开始胃镜操作待结束再行结肠镜操作。观察给药前,给药后1 min、5 min和检查结束时三组患者的平均动脉压（MAP）、心率（HR）、血氧饱和度（Sp O2）和不良反应发生情况。结果 A组患者的MAP和Sp O2在给药后1 min和5 min时与给药前比较,差异有统计学意义（P〈0.05）;三组患者的HR在给药后各时点与给药前比较均无统计学差异（P〉0.05）。C组与A组相比注射痛发生率明显减少（P〈0.05）,与B组相比,肌阵挛发生的发生率和恶心呕吐的发生率也明显下降（P〈0.05）。结论依托咪酯脂肪乳联合丙泊酚对患者对呼吸、循环影响小,麻醉安全性高,不良反应轻。Objective To observe application effect and feasibility of etomidate fat emulsion combined propofol used in comfortable gastroscopy and colonoscopy.Methods 180 patients under comfortable gastroscopy and colonoscopy with ASA I ~ III voluntary were divided into the propofol group（ Group A）,the etomidate group（ Group B） and the etomidate fat emulsion combined with propofol group（ Group C） according to the anesthesia methods,60 cases in each group.The three groups were used the intravenous injection of fentanyl 0.5 to 1.0 mg.After one minute,Group A was for the intravenous injection of propofol 1.5 to 2.0 mg / kg,Group B was for the intravenous injection of etomidate fat emulsion 0.3 mg / kg and Group C was for the intravenous injection of propofol 0.5 to 0.8 mg / kg and then etomidate 0.15 mg / kg.The endoscopic operation was used when the eyelash reflex disappeared,and then the colonoscopy was operated.The mean arterial pressure（ MAP）,heart rate（ HR）,blood oxygen saturation（ Sp O2）and adverse reactions were observed in the three groups after and before administration of 1min,5 min and the end of the examination.Results The difference of Map and Sp O2 in the Group A after administration of 1 min and 5 min and before administration had statistical significance（ P〉0.05）.Compared with before administration,the HRin the three groups showed no significant difference（ P〈0.05）.The incidence rate of pain in the Group C was lower than that of the Group A（ P〈0.05）,but the incidence rate of myoclonus and nausea and vomiting decreased significantly than that of the Group B（ P〈0.05）.Conclusion The etomidate fat emulsion combined propofol used in comfortable gastroscopy and colonoscopy showed less influence upon respiration and circulation.The safety of anesthesia was high,and the adverse reactions were mild.

关 键 词：依托咪酯脂肪乳 丙泊酚 舒适 胃镜+结肠镜检查 

分 类 号：R573[医药卫生—消化系统] R574[医药卫生—内科学]