临床麻醉与研究.docVIP

临床麻醉与研究 文章名首字母：G H I J K L M N lc0479 静脉麻醉在内镜检查中的应用 王震、雷勇静、杜筱玲 241000 王震 雷勇静 杜筱玲 摘要：目的：研究静脉麻醉药咪唑安定和异丙酚联合应用于内镜检查中的可行性和安全性。方法：ＡＳＡⅡ级以下，镇静组胃镜检查者60例、结肠镜检查者36例，同期普通胃镜60例、肠镜36例为对照组；观察在静脉麻醉下生命体征的变化, 镇静效果分级、并发症发生率（呼吸抑制、血压下降、恶心、呕吐、咳嗽和躁动）以及用药总量、检查后清醒时间（呼之睁眼、可回答问题）和离室时间，并与对照组比较。结果：镇静组效果分级在4～5级，对内镜操作无记忆，且在进境、退镜时血压、心率与入室时基本无异，而对照组在进镜时血压、心率有明显升高；两组比较（P〈0.05〉有显著性差异。镇静组恶心呕吐、咳嗽、躁动、咽部不适发生率分别为0、8.3％、10％、0，而对照组分别为38%、1.7％、28％、24％；镇静组清醒时间为7.86±2.21min,术毕室内留滞时间为18.25±3.56min，而对照组室内留滞时间为5.12±1.32min；胃镜总用药量咪唑安定2±0.25mg，异丙酚100±20mg；肠镜咪唑安定2±0.25mg，异丙酚150±30mg；结论：静脉麻醉下的内镜检查是操作简单、安全可行的，其术毕室内留滞时间较普通内镜检查稍长, 应由经验丰富的麻醉医师和内镜检查医师合作完成，在检查室内应常规配备急救药品和器械，以确保安全。 关键词 静脉麻醉 咪唑安定 异丙酚 胃镜 肠镜 [Abstract] Objective: Studying the feasibility and safety of joint application of midazolam and propofol during endoscopic procedures. Method:ＡＳＡⅡ class below, 60 cases of gastroscopy and 36cases of colonscopy in sedative group were given intravenous midazolam and propofol ,in controlling group, 60 cases of gastroscopy and 30 cases of colonscopy were given routine procedures; the changes of Blood pressure(BP),heart rate(HR),pulse oxygen saturation(SpO2),the grade of sedation effect, the rate of complications(breath repress, blood pressure descent ,nausea, vomiting, cough and restlesess) ,total dose, the time of waking ( shout it open eyes, can answer question) the time of leaving room in sedative group were compared with controlling group . Result: In sedative group,the grade of sedation effect is in 4 ～5 classes, no memory of examination. entering and backing the endoscopic, the change of blood pressure,and heart rate is slight. But in controlling group, blood pressure and heart rate go up obviously when examination. Comparing two group （P〈0.05〉has significant difference.The incidence of nausea and vomiting , cough , restlesess ,swallow discomfort in sedative group (0, 8.3%,10%,and0, respectively) was remarkable lower than that of control group(38%,17%,28%and24%, respectively,P0.05); In sed