中度镇静在肥胖患者无痛胃镜检查中的应用效果  

Application of moderate sedation in obese patients undergoing painless gastroscopy

作　　者：齐立杰 周赞宫[1] 冀翔宇[1] 王黎[1] 于宁[1] 张勇[2] 王萍萍[1] 刘印环 Qi Lijie;Zhou Zangong;Ji Xiangyu;Wang Li;Yu Ning;Zhang Yong;Wang Pingping;Liu Yinhuan(Department of Ambulatory Anesthesia,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Transplantation,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院日间麻醉科,青岛266000 [2]青岛大学附属医院移植科,青岛266000

出　　处：《国际麻醉学与复苏杂志》2024年第3期265-269,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：目的探讨中度镇静在肥胖患者无痛胃镜检查中的应用效果。方法选择2020年4月—2023年4月行无痛胃镜检查的肥胖患者120例,按随机数字表法分为观察组和对照组,每组60例。观察组实施中度镇静,对照组实施全身麻醉。记录两组患者麻醉前(T_(0))、给药结束时(T_(1))、胃镜通过咽喉时(T_(2))、胃镜检查结束时(T_(3))的脉搏血氧饱和度(SpO_(2))、平均动脉压(MAP),记录胃镜检查时间、麻醉苏醒时间、离院时间、丙泊酚用量及胃镜检查过程中的贲门暴露程度评分及胃镜检查后24 h内患者舒适度、患者满意度、医师满意度评分,记录检查过程中及苏醒后的不良反应发生情况。结果观察组T_(1)、T_(2)时SpO_(2)高于对照组(均P<0.05),T_(1)、T_(2)、T_(3)时MAP高于对照组(均P<0.05)。对照组T_(1)、T_(2)时SpO_(2)低于T_(0)时(均P<0.05),T_(1)、T_(2)、T_(3)时MAP低于T_(0)时(均P<0.05);观察组T_(1)、T_(2)时MAP低于T_(0)时(均P<0.05)。观察组麻醉苏醒时间、丙泊酚用量低于对照组(均P<0.05),贲门暴露程度4分占比高于对照组(P<0.05),缺氧、低血压发生率低于对照组(均P<0.05)。其余指标差异无统计学意义(均P>0.05)。结论肥胖患者无痛胃镜检查采用中度镇静相对于全身麻醉能有效减轻对呼吸及循环功能的影响,提高无痛胃镜检查的安全性,且贲门暴露程度更好,缺氧、低血压发生率更低,患者舒适度、满意度及医师满意度均较高。Objective To evaluate the application of moderate sedation in obese patients during painless gastroscopy.Methods A total of 120 obese patients who underwent painless gastroscopy from April 2020 to April 2023 were selected.According to the random number table method,they were divided into two groups(n=60):an observation group and a control group.Moderate sedation was conducted in the observation group,while general anesthesia was performed in the control group.Their pulse oxygen saturation(SpO_(2))and mean arterial pressure(MAP)were recorded before anesthesia(T_(0)),at the end of drug administration(T_(1)),when the gastroscope passed through the throat(T_(2)),and at the end of gastroscopy(T_(3)).The time of gastroscopy,the time of awakening from anesthesia,the time to discharge,the amount of propofol,and the score of cardia exposure during gastroscopy were recorded in both groups.Furthermore,the scores of patient comfort,patient satisfaction,and physician satisfaction within 24 h after gastroscopy were also collected.The incidences of adverse reactions during the examination and after awakening were recorded.Results For the observation group,SpO_(2) at T_(1) and T_(2) was higher than that in the control group(all P<0.05),while MAP at T_(1),T_(2),and T_(3) was higher than that in the control group(all P<0.05).In the control group,SpO_(2) at T_(1) and T_(2) was lower than that at T_(0)(all P<0.05),and MAP at T_(1),T_(2),T_(3) was lower than that at T_(0)(all P<0.05).In the observation group,MAP at T_(1) and T_(2) was lower than that at T_(0)(all P<0.05).The observation group showed decreases in the time of awakening from anesthesia and the amount of propofol(all P<0.05),increases in the percentage of 4 points of cardia exposure(P<0.05),and decreases in the incidence of hypoxia and hypotension,compared with the control group(all P<0.05).There was no statistical differences in other indicators(all P>0.05).Conclusions Compared with general anesthesia,moderate sedation for painless gastroscopy in obese patients can effe

关 键 词：中度镇静 肥胖 胃镜检查 血氧饱和度 舒芬太尼 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]