超声内镜检查中右美托咪定中度镇静的应用评价  

Evaluation of the application of dexmedetomidine for moderate sedation in endoscopic ultrasonography

作　　者：涂虹 王霞[1] 向顺菊 蔡莉 胡兵[3] 谭庆华[3] 王晓[1] TU Hong;WANG Xia;XIANG Shunju;CAI Li;HU Bing;TANG Qinghua;WANG Xiao(Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;West China School of Nursing,Sichuan University/Department of Anesthesiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]四川大学华西护理学院/四川大学华西医院麻醉科,成都610041 [3]四川大学华西医院消化内科,成都610041

出　　处：《华西医学》2021年第3期379-384,共6页West China Medical Journal

基　　金：国家自然科学基金(81872801)。

摘　　要：目的评估行超声内镜检查的患者中右美托咪定中度镇静的应用情况。方法选取2019年2月-6月四川大学华西医院拟行超声内镜检查的患者,随机分为右美托咪定组(试验组)和丙泊酚组(对照组)。比较两组患者的基本情况、超声内镜诊疗的成功率、镇静相关不良事件、实施气道管理的情况、术后舒适度评价和内镜医师满意度评分。结果最终纳入120例患者,每组各60例。两组患者的基本情况差异无统计学意义(P>0.05)。两组患者的超声内镜诊疗成功率均为100%。两组的呛咳、呼吸暂停和心动过缓发生率差异无统计学意义(P>0.05)。试验组的低血压(15.0%vs. 31.7%)和低氧血症(6.7%vs. 20.0%)发生率低于对照组,差异均有统计学意义(P<0.05)。试验组患者实施气道管理的比例低于对照组(1.7%vs. 28.3%),差异有统计学意义(P<0.05)。两组的术后疼痛评分、第1次下床活动时间和术后15项恢复质量量表评分差异无统计学意义(P>0.05)。试验组的术后6 h恶心呕吐发生率(48.3%vs. 3.3%)和术后24 h恶心呕吐发生率(10.0%vs. 0.0%)高于对照组,胃肠功能恢复所需时间比对照组长[(201.4±178.4)vs.(148.5±75.7)min],差异均有统计学意义(P<0.05)。试验组患者舒适度评分和内镜医师满意度评分中位数(下、上四分位数)分别为8(6,10)分和8(7,9)分,对照组评分分别为10(9,10)分和9(8,10)分,差异均有统计学意义(P<0.05)。结论右美托咪定中度镇静用于超声内镜检查具有较好的镇静镇痛效果,对呼吸和血压影响较小,但术后恶心呕吐发生率较高,患者舒适度和内镜医师满意度也有待提高。Objective To evaluate the application of dexmedetomidine for moderate sedation in patients undergoing endoscopic ultrasonography. Methods Patients who were planned to undergo endoscopic ultrasonography in West China Hospital of Sichuan University from February to June 2019 were randomly divided into dexmedetomidine group(trial group) and propofol group(control group). The basic conditions, success rate of endoscopic ultrasound diagnosis and treatment, sedation-related adverse events, implementation of airway management, postoperative comfort evaluation and endoscopic physician satisfaction score of the two groups were compared. Results A total of 120 patients were eventually enrolled, 60 in each group. There was no significant difference in the basic conditions of the two groups(P>0.05). The success rate of endoscopic ultrasound diagnosis and treatment in two groups were 100%. There was no significant difference in the incidence of bucking, apnea and bradycardia between the two groups(P>0.05). The incidence of hypotension(15.0% vs. 31.7%), hypoxemia(6.7% vs.20.0%) in the trial group was lower than those in the control group,the differences were statistically significant(P<0.05). The proportion of patients in the trial group who performed airway management was lower than that in the control group(1.7% vs. 28.3%), and the difference was statistically significant(P<0.05). There was no significant difference in postoperative pain score, the first time to get out of bed and postoperative15-item quality of recovery questionnaire score between the two groups(P>0.05). The incidence of nausea and vomiting at6 hours after operation(48.3% vs. 3.3%) and 24 hours after operation(10.0% vs. 0.0%) and the time required for recovery of gastrointestinal function [(201.4±178.4) vs.(148.5±75.7) min] in the trial group were higher than those in the control group(P<0.05). The median(the lower and upper quartile) of comfort score of patients and satisfaction score of endoscopic physicians were 8(6, 10) and 8(7, 9) in the trial group,

关 键 词：超声内镜 镇静 应用评价 

分 类 号：R614[医药卫生—麻醉学]