异丙酚复合咪达唑仑、芬太尼用于胃镜检查治疗术的麻醉效果.docVIP

异丙酚复合咪达唑仑、芬太尼用于胃镜检查治疗术的麻醉效果 　　[摘要] 目的 观察异丙酚复合咪达唑仑、芬太尼用于胃镜检查治疗的麻醉效果。 方法 选取拟行食管静脉曲张套扎术的肝硬化患者80例，采用抽签法随机分为两组，分别接受异丙酚+芬太尼（A组），异丙酚+咪达唑仑+芬太尼（B组）麻醉，比较术中的不良反应、术后的定向力恢复时间。 结果 与A组比较，B组的定向力恢复时间显著缩短，异丙酚的追加次数显著减少（P0.05）；B组的低血氧、呼吸暂停、肢体活动发生率与A组比较，显著降低（P0.05）。 结论 胃镜下套扎术黏膜层加固硬化操作中应用异丙酚复合咪达唑仑、芬太尼方法麻醉安全、有效，值得临床推广应用。 　　[关键词] 异丙酚；咪达唑仑；芬太尼；胃镜检查 　　[中图分类号] R614.2+4 [文献标识码] A [文章编号] 1674-4721（2013）11（c）-0175-02 　　Anesthetic effect of propofolum combined with midazolam and fentanyl on gastroscopy 　　MA Dong-mei CHI Ping QUAN Zhe-feng LI Xin HE Hai-li ZHANG Ying 　　Department of Anesthesia，Beijing Youan Hospital Affliated to Capital Medical University，Beijing 100069，China 　　[Abstract] Objective To observe the anesthetic effect of propofolum combined with midazolam and fentanyl on gastroscopy. Methods 80 patients with liver cirrhosis scheduled for esophageal variceal ligation were selected and randomly divided into two groups by lottery.Ppropofolum combined with fentanyl were given in the group A and propofolum，midazolam and fentanyl were given in the group B.The intraoperative adverse reaction and recovery time of postoperative orientation were compared. Results In comparison with the group A，the recovery time of orientation shortened obviously and frequency of adding propofolum remarkably reduced.in the group B （P0.05）；incidence rate of hypoxemia，apnoea and limb exercise in the group A significantly decreased（P0.05）. Conclusion Anesthesia of propofolum，midazolam and fentanyl is safe and effective in the operation of ligation with mucous layer strengthening and hardening by gastroscope.It is worthy of clinical promotion and application. 　　[Key words] Propofolum；Midazolam；Fentanyl；Gastroscopy 　　胃镜下套扎术黏膜层加固硬化术不同于一般胃镜检查术，该治疗操作时间大多长达10 min以上，且操作刺激较大，操作过程中患者容易出现体动，不利于操作的顺利进行，所以对麻醉要求更高。一般胃镜检查术常采用的麻醉方法为异丙酚复合芬太尼麻醉，目前关于胃镜下套扎术黏膜层加固硬化术选用何种麻醉方法的文章并不多见。本研究拟通过观察胃镜下套扎术加固硬化治疗术患者异丙酚复合咪达唑仑、芬太尼麻醉的效果，为临床麻醉工作提供参考。 　　1 资料与方法 　　1.1 一般资料 　　本研究设计经过本院伦理委员会的核准，拟行食管静脉曲张套扎术的肝硬化患者80例，ASA 分级Ⅰ～Ⅲ级，年龄26～56岁，体重指数