不同配比依托咪酯-丙泊酚复合应用于成年患者无痛胃镜的临床效果  

The clinical efficacy of different proportions of etomidate-propofol mixture for painless gastroscopy in adult patients

作　　者：黄佳 沈健 杨孟昌 魏新川[1,2] HUANG Jia;SHEN Jian;YANG Meng-chang;WEI Xin-chuan(School of Medicine,University of Electronic Science and Technology,Chengdu 610054,China;Department of Anesthesiology,Sichuan Academy of Medical Sciences&Sichuan Provincial People’s Hospital,Chengdu 610072,China)

机构地区：[1]电子科技大学医学院,四川成都610054 [2]四川省医学科学院·四川省人民医院麻醉科,四川成都610072

出　　处：《实用医院临床杂志》2021年第6期102-106,共5页Practical Journal of Clinical Medicine

摘　　要：目的比较不同配比依托咪酯和丙泊酚混合液(EPM)应用于成年患者无痛胃镜的临床效果和安全性。方法选择拟行无痛胃镜检查的患者177例,随机数字法分为3组。A组54例,静脉推注丙泊酚;B组58例,静脉推注1∶2体积比EPM;C组65例,静脉推注1∶3体积比EPM。所有患者常规监测,检查前4分钟静脉推注芬太尼0.03μg/kg,按分组于40秒内静脉推注试验药物0.2 ml/kg。未达入睡标准则再予试验用药0.05 ml/kg,直至达标,行胃镜检查。比较三组血压、心率、呼吸、脉搏氧饱和度、舒适度、满意度、清醒度、定向力评分以及不良反应。结果B、C组镇静低血压和低氧血症发生率明显低于A组;B组低氧血症发生率低于C组,差异有统计学意义(P<0.05)。其余指标差异无统计学意义(P>0.05)。结论EPM用于无痛胃镜诊疗镇静临床效果和安全性优于单用丙泊酚,其中1:2体积比混合液最佳。Objective To compare the clinical efficacy and safety of etomidate and propofol mixture(EPM)at different proportions for painless gastroscopy in adult patients.Methods One hundred and seventy-seven patients scheduled for painless gastroscopy were randomly divided into 3 groups(A,B and C groups).The group A(n=54)was given propofol only.The group B(n=58)was given EPM at 1:2 volume ratio.The group C(n=65)was given EPM at 1:3 volume ratio.All patients were routinely monitored.Fentanyl(0.03μg/kg)was injected intravenously 4 minutes before the examination and the trial medicine(0.2 ml/kg)was administered slowly and completed within 40 seconds by groups.If the standard for falling asleep was not reached,then the trial medication would be administered again at 0.05 ml/kg until the standard was reached before gastroscopy examination.Blood pressure,heart rate,respiration,pulse oxygen saturation,comfort,satisfaction,wakefulness,orientation score,and adverse reactions were compared among the three groups.Results The incidence of hypotension and hypoxemia during sedation in the groups B and C was lower than that in the group A(P<0.05).The incidence of hypoxemia in the group B was lower than that in the group C(P<0.05).There was no statistical difference in the remaining indexes(P>0.05).Conclusion The efficacy and safety of EPM in patients with painless gastroscopy are better than those of propofol alone.EPM at 1:2 volume ratio is the best.

关 键 词：依托咪酯 丙泊酚 胃镜 镇静 

分 类 号：R614.24[医药卫生—麻醉学]