丙泊酚联合依托咪酯在老年无痛胃肠镜检查中的效果观察和安全性分析

doi:10.3969/j.issn.1674-490X.2021.01.003

摘要/Abstract

摘要： 目的观察丙泊酚联合依托咪酯用于老年无痛胃肠镜的临床效果,并对其安全性进行评价。方法选择2019年1月至2020年1月于河北省唐山市丰润区第二人民医院行无痛胃镜和肠镜检查的老年患者96例作为研究对象,进行前瞻性随机对照研究。根据检查时麻醉药物的不同按照数字随机表法分为A组和B组,每组48例,A组给予丙泊酚麻醉,B组给予依托咪酯联合丙泊酚。检查结束后,比较2组患者的麻醉效果(麻醉诱导时间、苏醒时间、定向力恢复时间)、血清学指标(肾上腺素、去甲肾上腺素、皮质醇)及不良反应发生情况。结果(1)B组患者的麻醉诱导时间、苏醒时间、定向力恢复时间均显著低于A组,差异有统计学意义(P<0.05);(2)与同组检查前相比,麻醉30 min 2组患者血清皮质醇、肾上腺素、去甲肾上腺素水平均显著升高,差异有统计学意义(P<0.05);B组麻醉30 min血清肾上腺素、去甲肾上腺素、皮质醇水平低于A组,差异有统计学意义(P<0.05);(3)不良反应发生率B组显著低于A组,差异有统计学意义(P<0.05)。结论老年患者进行无痛胃肠镜检查时,应用丙泊酚联合依托咪酯麻醉,可提高检查时的麻醉效果,改善检查时的应激反应,降低不良反应的发生。

关键词: 丙泊酚, 依托咪酯, 无痛胃肠镜, 临床效果, 安全性

Abstract: Objective To observe the application of propofol combined with etomidate in painless gastrointestinal endoscopy for the elderly, and evaluate the clinical effect and safety of the two drugs combined. Methods A prospective, randomized, controlled study was conducted among 96 elderly patients selected and randomly divided into two groups according to different anesthesia methods admitted to the Second People's Hospital of Fengrun District, Tangshan City, Hebei Province for painless gastroscopy from January 2019 to January 2020. 48 cases in the group A were given propofol combined with etomidate anesthesia, while 48 cases in the group B were given propofol anesthesia. After the examination, the anesthetic effect(anesthesia induction time, recovery time, directional recovery time), serological indicators(epinephrine, norepinephrine, cortisol)and adverse reactions were compared between the two groups. Results(1)Anesthesia induction time, recovery time and orientation recovery time of group B were significantly lower than those of group A(P<0.05).(2)Compared with that before examination in the same group, the serum cortisol, epinephrine and norepinephrine levels in the two groups were significantly increased(P<0.05)and the serum levels of epinephrine, norepinephrine and cortisol in group B were lower than those in group A(P<0.05).(3)The incidence of adverse reactions in group B was significantly lower than that in group A(P<0.05). Conclusion The application of propofol combined with etomidate anesthesia in elderly patients with painless gastroenteroscopy can improve the anesthetic effect, improve the stress reaction and reduce the incidence of adverse reactions.

Key words: propofol, etomidate, painless gastroscopy, clinical effect, security

中图分类号:

R971

赵元奎. 丙泊酚联合依托咪酯在老年无痛胃肠镜检查中的效果观察和安全性分析[J]. 医学研究与教育, 2021, 38(1): 17-22.

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