依托咪酯联合丙泊酚用于老年患者无痛胃肠镜检查的麻醉效果及对患者认知功能的影响  

The Anesthetic Effect of Etomidate Combined with Propofol for Painless Gastrointestinal Endoscopy in Elderly Patients and Its Influence on Patients'Cognitive Function

作　　者：丘春华[1] 李粮辉 陈婷[1] QIU Chunhua;LI Lianghui;CHEN Ting(Department of Anesthesiology,Fujian Provincial Clinical Medical College,Fujian Medical University(Fujian Jinshan Hospital),Fuzhou,Fujian Province,350008 China)

机构地区：[1]福建医科大学省立临床医学院(福建省立金山医院)麻醉科,福建福州350008

出　　处：《中外医疗》2022年第4期114-118,共5页China & Foreign Medical Treatment

摘　　要：目的分析老年无痛胃肠镜检查患者接受依托咪酯联合丙泊酚治疗的麻醉效果,及此联合麻醉方式对患者认知功能的影响。方法随机选择2018年6月—2021年3月该院收治的80例老年无痛胃肠镜检查患者作为研究对象,按随机分组法,分为观察组(40例,在对照组基础上加上依托咪酯进行联合麻醉)和对照组(40例,行丙泊酚与舒芬太尼联合麻醉)。对比两组患者的麻醉状态、认知能力MMSE评分、生命体征变化、不良反应发生情况。结果观察组患者的麻醉诱导时间(32.98±4.94)s、苏醒时间(22.03±4.28)min、定向力恢复时间(25.03±0.93)min,对照组分别为(37.83±8.32)s、(28.83±4.98)min、(30.93±2.84)min,观察组所用时间明显短于对照组,差异有统计学意义(t=3.170、6.550、12.487,P=0.002、0.001、0.001)。观察组患者麻醉后15 min、麻醉后30 min、麻醉后1 h的MMSE评分分别为(26.67±1.53)分、(26.56±1.12)分、(27.14±1.43)分,对照组分别为(20.01±1.12)分、(20.17±1.15)分、(25.03±1.18)分,观察组的MMSE评分明显高于对照组,差异有统计学意义(t=22.215、25.176、7.198,P=0.001、0.001、0.001)。观察组患者麻醉后5 min、麻醉后1 h的收缩压、舒张压分别为(139.92±4.62)、(135.73±4.03)、(82.81±2.21)、(82.55±2.27)mmHg,对照组分别为(112.73±3.23)、(132.81±3.82)、(67.65±1.54)、(72.74±1.27)mmHg,观察组检测值明显高于对照组,差异有统计学意义(t=30.506、3.326、35.595、23.853,P=0.001、0.001、0.001、0.001)。观察组患者的不良反应总发生率(10.00%)与对照组(12.50%)相比差异无统计学意义(χ^(2)=0.000,P=1.000)。结论将依托咪酯联合丙泊酚麻醉方式应用到老年无痛胃肠镜患者的检查中,能提升其整体的麻醉效果,降低患者认知功能的受影响程度,可达更好的临床疗效,值得推广应用。Objective To analyze the anesthesia effect of etomidate combined with propofol in elderly patients undergoing painless gastrointestinal endoscopy,and the effect of this combined anesthesia on the cognitive function of patients.Methods Eighty elderly patients with painless gastroenteroscopy admitted to the hospital from June 2018 to March 2021 were selected as the research objects.According to random grouping method,they were divided into observation group(40 cases,combined anesthesia with etomidate on the basis of control group)and control group(40 cases,combined anesthesia with propofol and sufentanil).Anesthesia status,MMSE score of cognitive ability,changes of vital signs and occurrence of adverse reactions were compared between the two groups.Results The anesthesia induction time(32.98±4.94)s,recovery time(22.03±4.28)min and recovery time of directional force(25.03±0.93)min in the observation group were(37.83±8.32)s,(28.83±4.98)min and(30.93±2.84)min in the control group respectively,the time used in the observation group was significantly shorter than that in the control group,the difference was statistically significant(t=3.170,6.550,12.487,P=0.002,0.001,0.001).The MMSE scores of patients in the observation group at 15 min,30 min and 1 h after anesthesia were(26.67±1.53)points,(26.56±1.12)points,(27.14±1.43)points and(20.01±1.12)points,(20.17±1.15)points and(25.03±1.18)points respectively,the MMSE scores of the observation group were significantly higher than those of the control group,the difference was statistically significant(t=22.215,25.176,7.198,P=0.001,0.001,0.001).The systolic blood pressure and diastolic blood pressure of the patients in the observation group were(139.92±4.62)mmHg,(135.73±4.03)mmHg,(82.81±2.21)mmHg,(82.55±2.27)mmHg and(112.73±3.23)mmHg,(132.81±3.82)mmHg,(67.65±1.54)mmHg,(72.74±1.27)mmHg respectively at 5 min and 1 h after anesthesia,the detection values of the observation group were significantly higher than those of the control group,the difference was statisti

关 键 词：老年 无痛胃肠镜检查 依托咪酯 丙泊酚 麻醉效果 认知功能 

分 类 号：R4[医药卫生—临床医学]