不同剂量丙泊酚靶控输注麻醉对内镜逆行性胰胆管造影联合内镜括约肌切开术下胆总管结石患者血流动力学镇痛及安全性的影响  

Effects of different doses of propofol target-controlled infusion anesthesia on hemodynamics,analgesia,and safety in patients with common ble duct stones undergoing endoscopic retrograde cholangiopancre-atography combined with endoscopic sphincterotomy

作　　者：吴继敏[1] 单伟锋 徐巧敏[1] 梅培毅 游敏吉[1] Wu Jimin;Shan Weifeng;Xu Qiaomin;Mei Peiyi;You Minji(Department of Anesthesiology,Lishui People′s Hospital,Lishui,Zhejiang 323000,China)

机构地区：[1]丽水市人民医院麻醉科,浙江丽水323000

出　　处：《中国药物与临床》2024年第13期847-852,共6页Chinese Remedies & Clinics

基　　金：浙江省医药卫生科技项目(2019KY799)。

摘　　要：目的探讨不同剂量丙泊酚靶控输注麻醉在内镜逆行性胰胆管造影(ERCP)联合内镜下括约肌切开术治疗胆总管结石的临床观察。方法2019年12月至2023年1月选取浙江省丽水市人民医院就诊的300例胆总管结石并行ERCP联合内镜下括约肌切开术的患者,按剂量将其分为低剂量丙泊酚(LP)组,中剂量丙泊酚(MP)组和高剂量丙泊酚(HP)组,每组100例,LP组、MP组、HP组均进行丙泊酚靶控输注,剂量分别为1μg/ml、3μg/ml、5μg/ml,观察并分析3组临床相关指标。结果T0、T1、T2、T3、T4、T5时LP组的平均动脉压(MAP)分别为(88±6)mmHg、(77±5)mmHg、(71±5)mmHg、(70±5)mmHg、(75±5)mmHg、(84±7)mmHg;MP组分别为(87±6)mmHg、(78±5)mmHg、(70±5)mmHg、(70±5)mmHg、(76±6)mmHg、(83±6)mmHg;HP组分别为(88±6)mmHg、(77±5)mmHg、(71±5)mmHg、(71±5)mmHg、(75±5)mmHg、(83±6)mmHg。T0、T1、T2、T3、T4、T5时LP组的心率分别为(78±6)次/min、(73±5)次/min、(67±5)次/min、(68±5)次/min、(71±6)次/min、(80±6)次/min;MP组分别为(78±6)次/min、(72±5)次/min、(68±5)次/min、(67±5)次/min、(71±6)次/min、(80±6)次/min;HP组分别为(78±6)次/min、(73±5)次/min、(67±5)次/min、(67±5)次/min、(72±6)次/min、(79±6)次/min。在T0时,3组MAP、心率水平、视觉模拟评分(VAS)对比差异无统计学意义(P>0.05),在T1、T2时,3组的MAP、心率均降低(P<0.05),但3组MAP、心率水平对比差异无统计学意义(P>0.05),T2与T3时3组MAP、心率水平对比差异无统计学意义(P>0.05),而在T4、T5时,3组MAP、心率水平均升高,但3组MAP、心率水平对比差异无统计学意义(P>0.05),组间与时间不存在相互作用(F=0.249,P=0.991)。T0、T1、T2、T3、T4、T5时LP组的VAS评分分别为(4.25±0.22)分、(2.34±0.15)分、(2.41±0.16)分、(2.38±0.14)分、(4.33±0.23)分、(5.21±0.26)分;MP组分别为(4.35±0.24)分、(1.85±0.14)分、(1.82±0.13)分、(1.84±0.12)分、(3.65±0.14)分、(4.78±0.21)分;HP组分别为(4.30±Objective To investigate the clinical observation of different doses of propofol target controlled infusion anesthesia in the treatment of choledocholithiasis by ERCP combined with endoscopic sphinctero-tomy.Methods A total of 300 patients with choledocholithiasis undergoing ERCP combined with endoscopic sphincterotomy at Lishui People′s Hospital from December 2019 to January 2023 were selected and divided into low-dose propofol(LP)group,medium-dose propofol(MP)group,and high-dose propofol(HP)group,with 100 cas-es in each group.The LP group,MP group,and HP group were all administered propofol target controlled infusion at doses of 1,3,and 5μg/ml,respectively.The clinically relevant indicators of the three groups were observed and analyzed.Results The MAP of LP group at T0,T1,T2,T3,T4 and T5 were(88±6)mmHg,(77±5)mmHg,(71±5)mmHg,(70±5)mmHg,(75±5)mmHg and(84±7)mmHg,respectively;The MP group was(87±6)mmHg,(78±5)mmHg,(70±5)mmHg,(70±5)mmHg,(76±6)mmHg,(83±6)mmHg,respectively.The HP group was(88±6)mmHg,(77±5)mmHg,(71±5)mmHg,(71±5)mmHg,(75±5)mmHg,(83±6)mmHg,respectively.The HR of LP group at T0,T1,T2,T3,T4 and T5 were(78±6)beats per minute,(73±5)beats per minute,(67±5)beats per minute,(68±5)beats per minute,(71±6)beats per minute and(80±6)beats per minute,respectively;MP group was(78±6)beats per minute,(72±5)beats per minute,(68±5)beats per minute,(67±5)beats per minute,(71±6)beats per minute,(80±6)beats per minute,respectively.They were(78±6)beats per minute,(73±5)beats per minute,(67±5)beats per minute,(67±5)beats per minute,(72±6)beats per minute,(79±6)beats per minute,respectively.At T0,there were no significant differences in MAP,HR levels and VAS scores among the three groups(P>0.05);at T1 and T2,MAP and HR levels of the three groups were significantly decreased(P<0.05),but there were no signifi-cant differences in MAP and HR levels among the three groups(P>0.05).There was no significant difference in the comparison of MAP and HR levels among the three groups at T2 and T3(P>0.0

关 键 词：二异丙酚 麻醉静脉 胆石 括约肌切开术 内窥镜 

分 类 号：R614[医药卫生—麻醉学]