艾司氯胺酮复合丙泊酚用于抑郁症患者无痛胃肠镜检查的效果  

Efficacy of esketamine combinedd with propofol in patients with depression undergoinggpainless gastrointestinal endoscopy

作　　者：黄娟娟 肖小青 吴陈诚 程善飞[1] HUANG Juanjuan;XIAO Xiaoqing;WU Chencheng;CHENG Shanfei(Department of Anesthesiology,Huzhou Third People's Hospital,Huzhou 313000,CHINA)

机构地区：[1]湖州市第三人民医院麻醉科,浙江313000

出　　处：《江苏医药》2025年第1期52-55,共4页Jiangsu Medical Journal

基　　金：湖州市公益性应用研究医卫一般项目(2021GYB69)。

摘　　要：目的 探讨艾司氯胺酮复合丙泊酚用于抑郁症患者无痛胃肠镜检查的效果。方法 行无痛胃肠镜检查的抑郁症患者50例随机分为艾司氯胺酮复合丙泊酚组(E组)和舒芬太尼复合丙泊酚组(S组),每组25例。E组缓慢静脉注射艾司氯胺酮0.2mg/kg和丙泊酚1.5~2.5mg/kg;S组静脉注射舒芬太尼0.05μg/kg和丙泊酚1.5~2.5mg/kg。记录两组患者胃肠镜检查前1d和检查后1d的汉密尔顿抑郁量表(HAMD-17)评分和汉密尔顿焦虑量表(HAMA)评分。记录两组麻醉前(T1)、麻醉后即刻(T2)、入镜检查5min(T3)和检查结束(T4)时的HR、MAP和SpO_(2)。观察不良反应发生情况。结果 E组检查后1d的HAMD-17评分和HAMA评分均低于检查前1d,且低于S组(P<0.05)。与T1时比较,两组T2~T4时的HR和MAP降低,SpO_(2)升高(P<0.05);E组T2~T4时的HR和MAP高于S组(P<0.05)。两组检查时间、丙泊酚用量、VAS疼痛评分和不良反应发生率均无统计学差异(P>0.05)。结论 艾司氯胺酮复合丙泊酚用于抑郁症患者无痛胃肠镜检查可以提供有效的镇静、镇痛,维持循环稳定,可改善患者术后的抑郁症状。Objective To observe the efficacy of esketamine combined with propofol in the patients with depression undergoing painless gastrointestinal endoscopy.Methods Fifty patients with depression undergoing painless gastrointestinal endoscopy were randomly divided into two groups with 25 cases each.The patients in group E were slowly injected with esketamine 0.2 mg/kg and propofol 1.5-2.5 mg/kg.The patients in group S were slowly injected with sufentanil 0.05μg/kg and propofol 1.5-2.5 mg/kg.Hamilton depression scale(HAMD-17)score and Hamilton anxiety scale(HAMA)score of the two groups were evaluated one day before examination and one day after.The HR,MAP and SpO_(2) were recorded before anesthesia(T1),immediately after injection of anesthetics(T2),at 5 minutes during examination(T3)and at the end of examination(T4).The occurrence of adverse reactions was observed.Results HAMD-17 score and HAMA score of group E one day after examination were significantly lower than those one day before,which on one day after examination were lower in group E than those in group S(P<0.05).Compared with T1,the HR and MAP were decreased and SpOz was increased at T2 to T4 in two groups(P<0.05).The HR and MAP of group E were higher than those of group S at T2 to T4(P<0.05).There were no significant differences in examination time,propofol consumption,VAS pain score and the incidence of adverse reactions between the two groups(P>0.05).Conclusion Esketamine combined with propofol can provide effective sedation and analgesia during painless gastrointestinal endoscopy in the patients with depression,maintain circulation stability,and improve postoperative depressive symptoms.

关 键 词：艾司氯胺酮 丙泊酚 舒芬太尼 抑郁症 胃肠镜检查 

分 类 号：R275[医药卫生—中医皮科]