达克罗宁胶浆用于胃镜检查对咽炎患者咽反射的影响  

Effects of dyclonine hydrochloride mucilage on gag reflex in patients with chronic pharyngitis undergoing gastroscopy

作　　者：韩明杰[1] 蔡东妙[1] Han Mingjie;Cai Dongmiao(Department of Anesthesiology,The First Affiliated Hospital of Ximen University,Xiamen 361001,Fujian Province,China)

机构地区：[1]厦门大学附属第一医院麻醉科,厦门361001

出　　处：《中国基层医药》2023年第5期668-672,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨达克罗宁胶浆用于胃镜检查口咽表面麻醉对慢性咽炎患者咽反射的影响。方法选取厦门大学附属第一医院2020年1-12月收治的患有慢性咽炎择期行胃镜检查、且符合美国麻醉医师协会(ASA)分级Ⅰ~Ⅱ级患者100例为观察对象,采用双盲对照研究方法,根据自愿原则分为达克罗宁胶浆组(D组)与对照组(C组),每组50例。于麻醉诱导前10 min,D组患者给予达克罗宁胶浆10 mL,C组患者给予等容积安慰剂,口咽部含服,10 min后均吞咽入胃。麻醉诱导,芬太尼20μg静脉注射,丙泊酚2~4 mg/kg静脉注射,待患者意识消失,行胃镜检查。观察记录胃镜检查中患者呛咳及体动反应评分,麻醉诱导前(T0)、胃镜置入前(T1)、置入胃镜后(T2)及撤出胃镜后(T3)患者平均动脉压(MAP)与心率(HR)变化情况。结果D组呛咳发生率[20%(10/50)]和体动发生率[24%(12/50)]均显著低于C组[72%(36/50)、68%(34/50)](χ^(2)=27.21、19.49,均P<0.001);T1时D、C两组患者MAP[(62.21±10.32)mmHg、(63.82±10.51)mmHg](1 mmHg=0.133 kPa)均显著低于T0时[(70.21±13.13)mmHg、(70.91±14.02)mmHg](t=3.15、5.82,均P<0.05);T2时,C组患者MAP[(80.13±11.92)mmHg]、HR[(90.02±15.63)次/min]均明显高于T0时[(70.91±14.02)mmHg、(78.75±14.93)次/min](t=5.99、4.03,均P<0.05),也高于D组[(66.21±12.33)mmHg、(76.53±10.31)次/min](t=2.07、2.67,均P<0.05)。结论达克罗宁胶浆用于胃镜检查口咽表面麻醉可以明显降低慢性咽炎患者咽反射程度,血流动力学平稳。Objective To investigate the effects of dyclonine hydrochloride mucilage administered for oropharyngeal anesthesia on gag reflex in patients with chronic pharyngitis during gastroscopy.Methods A total of 100 patients with chronic pharyngitis who met American Society of Anesthesiologists Classification I-II and received treatment in The First Affiliated Hospital of Ximen University from January to December 2020 were included in this study.Using the principle of voluntariness,these patients were divided into dyclonine hydrochloride mucilage(D)and control(C)groups,with 50 patients in each group.Ten minutes before anesthesia induction,patients in Group D took 10 mL of dyclonine hydrochloride mucilage in the mouth,but did not swallow it,and those in Group C were identically given equal volume of placebo.Ten minutes later,dyclonine hydrochloride mucilage or placebo was swallowed.For anesthesia induction,20μg Fentanyl and 2-4 mg/kg Propofol were intravenously administered.A gastroscopy examination was performed after the patient's consciousness disappeared.The patient's cough and body movement response scores during gastroscopy were recorded.Before anesthesia induction(T0),before endoscope insertion(T1),after endoscope insertion(T2),and after endoscope withdrawal(T3),mean arterial pressure and heart rate were recorded.Results The incidence rate of cough and body movement in Group D were 20%(10/50)and 24%(12/50),which were significantly lower than 72%(36/50)and 68%(34/50)in Group C(χ^(2)=27.21,19.49,both P<0.001).At T1,mean arterial pressure in Group D and Group C was(62.21±10.32)mmHg and(63.82±10.51)mmHg(1 mmHg=0.133 kPa),respectively,which were significantly lower than(70.21±13.13)mmHg and(70.91±14.02)mmHg at T0(t=3.15,5.82,both P<0.05).At T2,mean arterial pressure and heart rate in Group C were(80.13±11.92)mmHg and(90.02±15.63)beats/minute,respectively,which were significantly higher than(70.91±14.02)mmHg and(78.75±14.93)beats/minute at T0 in the same group(t=5.99,4.03,both P<0.05)and were also significantly

关 键 词：胃镜检查 麻醉药 局部 麻醉 静脉 咽炎 慢性 作呕 咳嗽 血流动力学 呼吸功能不全 

分 类 号：R766.14[医药卫生—耳鼻咽喉科]