异丙酚复合芬太尼在无痛肠镜中临床观察.doc

异丙酚复合芬太尼在无痛肠镜中临床观察 　 ; 作者：冯如新，韩松，张刚，刘丽娟 毕业论文 【关键词】; 异丙酚；芬太尼；MAC技术；肠镜 毕业论文 ［摘要］; 目的; 探讨异丙酚复合芬太尼实施监护下麻醉管理(monitored anesthesia care,MAC)技术，应用于肠镜检查中的有效性和安全性。 方法; 200例行肠镜检查者随机分为MAC组(n=100)和对照组(n=100)，对照组行常规肠镜检查。MAC组以芬太尼1 μg/kg静脉注射，继以异丙酚1～2 mg/s速度推注，Ramsay镇静分级5级后行肠镜检查，术中5 ～10 mg/min速度维持MAC。结果; MAC 组无痛率100%，其中安静入睡98例(98%)，轻微肢体活动16例(16%)，明显肢体活动影响操作4例(4%)，清醒时间短，不良反应少，检查中生命体征平稳。对照组病例则有不同程度的腹胀、腹痛、大声喊叫、肢体活动及其他不适，不良反应多。结论; 异丙酚复合芬太尼MAC技术应用于肠镜检查，镇痛镇静效果确切，安全。 毕业论文 ; ［关键词］; 异丙酚；芬太尼；MAC技术；肠镜 毕业论文 ; Clinical observation on MAC by propofol combined with fentanyl in colonoscopy 毕业论文 ; ［Abstract］; Objective; To investigate the effect and safety of monitored anesthesia care(MAC)by propofol combined with fentanyl in colonoscopy. Methods; 200 patients attending for colonoscopy were randomly chosen and divided into control group(n=100)and MAC group(n=100).Control group was given normal colonoscopy.MAC group was given fentanyl (1μg /kg) and propofol (1～2 mg/s) intravenously.If the patients reached classⅤ of Ramsay score,inserted the colonoscope，and maintained with propofol 5～10 mg/min. Results; In MAC group,painless percentage was 100%,98 patients (98%)was sedately asleep,16 patients(16%)had lowgrade body movement,4 patient(4%) had obvious body movement,awake time was short,and the vital signs were stable during colonoscopy.In control group,all patients have different windy,bellyache,crying out,body movement or other discomfort.The incidence of adverse reaction in control group was higher than that in MAC group. Conclusion; The application of MAC by propofol combined with fentanyl in gastroscopy is safe,comfortable and effective. 毕业论文 ; ［Key words］; propofol;fentanyl;MAC;colonoscopy 毕业论文 ; 肠镜检查是下消化道疾病诊治的常见检查手段。以往由于肠镜检查时，检查时间较长，患者检查前焦虑，检查中腹痛、腹胀，一些患者不能耐受，喊叫，被迫中断或停止，不仅使患者痛苦，也增加了医务人员的操作难度，延长操作时间。我院2005年开展肠镜的监护下麻醉管理(manitored anesthesia care,MAC)技术，采用异丙酚复合芬太尼MAC技术下行肠镜检查，积累了一定的实践经验。现总结报告如下。 毕业论文 ; 1; 对象与方法 毕业论文 ; 1.1; 观察对象; 2005年1月～2006年8月行肠镜检查的患者200例，均为同一操作者操作。无肠