瑞芬太尼复合小剂量咪达唑仑在肥胖患者超声胃镜检查中的应用观察  

Application of Remifentanil Combined with Low-Dose Midazolam in Obese Patients Undergoing Ultrasound Gastroscopy

作　　者：马鸿军[1] 许卿[1] MA Hong-jun;XU Qing(Department of Outpatient,252 Hospital of PLA,Baoding,Hebei 071000,China)

机构地区：[1]解放军252医院门诊部,河北保定071000

出　　处：《临床误诊误治》2018年第8期32-39,共8页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨瑞芬太尼复合小剂量咪达唑仑在肥胖患者超声胃镜检查中的应用效果和安全性。方法选取拟行超声胃镜检查的肥胖患者120例,采用随机数字表法随机将其分为观察组和对照组两组各60例。观察组采用瑞芬太尼复合小剂量咪达唑仑进行麻醉,对照组输注等容积0.9%氯化钠注射液。观察比较两组麻醉前(T0)、检查中(T1)、检查结束时(T2)及术后10 min(T3)的收缩压(SBP)、心率(HR)和脉搏血氧饱和度(SpO_2),检查前及检查后1 h血清白细胞介素1β(IL-1β)和肿瘤坏死因子α(TNF-α)变化情况;记录比较两组检查中体动反应、恶心、呕吐、呛咳、头晕及心动过缓等不良反应发生情况;调查比较两组患者舒适度、愿意再次接受检查率及术者满意度、操作时间。结果 T1时,观察组SBP、HR较T0时下降,对照组SBP、HR较T0时升高;与观察组同一时间点比较,对照组T1和T2时SBP和HR升高,差异有统计学意义(P<0.05)。检查后1 h,观察组和对照组血清IL-1β和TNF-α均较检查前升高;观察组血清IL-1β和TNF-α低于对照组,差异有统计学意义(P<0.05)。观察组体动反应、恶心、呕吐、呛咳发生率及术者操作时间明显低于或短于对照组,患者舒适度、愿意再次接受检查率及术者满意度均明显高于对照组,差异具有统计学意义(P<0.05)。结论瑞芬太尼复合小剂量咪达唑仑在肥胖患者超声胃镜检查中可产生良好的镇静和镇痛效果,且安全性较高。Objective To explore the efficacy and safety of remifentanil combined with low-dose midazolam in obese patients undergoing ultrasound gastroscopy.Methods A total of 120 obese patients scheduled for ultrasound gastroscopy were randomly divided into the observation group(n=60)and the control group(n=60)by random number table.The observation group was anesthetized by remifentanil combined with low-dose midazolam,and the control group was infused with an equal amount of saline.The systolic blood pressure(SBP),heart rate(HR),and pulse oxygen saturation(SpO 2)were detected before anesthesia(T0),during the inspection(T1),at the end of the inspection(T2)and 10 min after the surgery(T3)in the two groups.The interleukin 1 inflammatory factor(IL-1β)and tumor necrosis factor(TNF-α)in serum were measured before examination and 1 h after the examination.The occurrence of adverse reactions,including physical reaction,nausea and vomiting,cough,dizziness and bradycardia during the examination were recorded.The patient's comfort and willingness to be reexamined,surgeon satisfaction and duration of operation were investigated.Results At T1,SBP and HR in observation group was significantly lower than that at T0,while SBP and HR in the control group were increased significantly.Compared with the observation group at the same time point,SBP and HR of the control group at T1,and T2 were increased,suggesting significant differences(P<0.05).One hour after the examination,the levels of IL-1βand TNF-αin the two groups were increased,which were lower in the observation group than in the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions such as physical reaction,nausea and vomiting,and cough as well as duration of operation in the observation group was significantly lower or shorter than that in the control group.In addition,the patient's comfort and willingness to be reexamined and surgeon satisfaction in the observation group were significantly better than those in the control gro

关 键 词：瑞芬太尼 咪达唑仑 肥胖 胃镜检查 超声检查 

分 类 号：R971.2[医药卫生—药品]