依托咪酯联合穴位刺激用于老年患者无痛结肠镜检查的临床观察  

Clinical Observation of Etomidate Combined with Acupoint Stimulation for Painless Colonoscopy in Elderly Patients

作　　者：郭丰[1] 于桂杰[1] 王兰[1] 高浩 冯睿[1] 袁岚[1] GUO Feng;YU Gui-jie;WANG Lan;GAO Hao;FENG Rui;YUAN Lan(Department of Anesthesiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai201203)

机构地区：[1]上海中医药大学附属曙光医院麻醉科,上海201203

出　　处：《世界中西医结合杂志》2022年第3期589-591,596,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金项目(81774108);上海市卫生健康委员会科研课题计划(201940062)。

摘　　要：目的 观察经皮穴位电刺激复合依托咪酯静脉全麻用于老年患者无痛结肠镜检查的临床疗效。方法 选取2020年6月—11月期间于上海中医药大学附属曙光医院内镜中心择期行无痛结肠镜检查术的老年患者120例,采用随机数字表法分为对照组和观察组,每组各60例。对照组依托咪酯静脉全麻,观察组经皮穴位电刺激复合依托咪酯静脉全麻。观察比较两组患者最低平均动脉压(Mean artery pressure, MAP)、最低心率(Heart rate, HR)、最低脉搏血氧饱和度(Spo_(2)),并计算MAP、HR、Spo_(2)变化情况;记录诱导时间、苏醒时间、完成自主动作时间、离开PACU时间及检查时间;记录患者低氧饱和度、呼吸道梗阻、肌颤、恶心呕吐等不良反应发生情况。结果 观察组最低MAP指数明显高于对照组,差异有统计学意义(P<0.05);观察组诱导时间明显优于对照组,差异有统计学意义(P<0.05);检查后观察组恶心、呕吐发生率8.33%(5/60)明显低于对照组33.33%(20/60),差异有统计学意义(P<0.05);对照组中级肌颤发生率20.00%(12/60)明显高于观察组5.00%(3/60),差异有统计学意义(P<0.05)。结论 经皮穴位电刺激复合依托咪酯静脉全麻用于老年患者无痛结肠镜检查术的循环波动更小,起效更快,不良反应发生率更低,值得临床推广。Objective To evaluate the clinical efficacy of transcutaneous electrical acupoint stimulation combined with intravenous anesthesia with etomidatein elderly patients undergoing painless colonoscopy.Methods This study enrolled 120 elderly patients(65~79 years old)undergoing painless colonoscopy in the EndoscopyCenter of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from June to November in 2020.The patients were randomly assigned into two groups: control group(etomidate, 60 cases)and observation group(transcutaneous acupoint electrical stimulation combined with etomidate, 60 cases).The lowest mean artery pressure(MAP),minimal heart rate(HR),and saturation of pulse oximetry(Spo_(2))were measured and compared between the two groups.The induction time, awakening time, time to involuntary movement, time to leave post-anesthesia care unit(PACU),and inspection time were recorded.The incidence of adverse reactions such as hypoxia, respiratory tract obstruction, muscular fibrillation, and nausea and vomiting was recorded.Results The observation group hadhigher lowest MAP(P<0.05),shorter induction time(P<0.05),lower incidence of nausea and vomiting[8.33%(5/60)v.s.33.33%(20/60),P<0.05],and lower incidence of muscular fibrillation[5.00%(3/60)v.s.20.00%(12/60),P<0.05] than the control group.Conclusion Transcutaneous acupoint electrical stimulation combined with intravenous anesthesia with etomidate for elderly patients undergoing painless colonoscopy is characterized byslight circulation fluctuation, fast onset, and low incidence of adverse reactions, which is worthy of promotion in clinical practice.

关 键 词：经皮穴位电刺激 依托咪酯 无痛结肠镜 

分 类 号：R245.99[医药卫生—针灸推拿学] R44[医药卫生—中医临床基础]