异丙酚和依托咪酯复合瑞芬太尼对老年无痛胃镜患者的呼吸循环系统影响的比较

发布时间：2018-03-14 05:51

本文选题：胃镜检查　切入点：呼吸系统　出处：《重庆医学》2017年05期 　论文类型：期刊论文

【摘要】：目的对比观察异丙酚和依托咪酯复合瑞芬太尼对老年无痛胃镜患者呼吸循环系统的影响。方法选择该院内镜中心行无痛胃镜的400例老年患者,采用异丙酚和依托咪酯复合瑞芬太尼静脉麻醉,并分为异丙酚组(n=200)和依托咪酯组(n=200)。观察两组患者在诊断结果、胃镜置入时间、操作时间、苏醒时间、血流动力学、不良反应和满意度上的差别。结果两组患者在诊断结果上差异无统计学意义(P0.05),在胃镜置入时间上依托咪酯组早于异丙酚组(P0.05)。在血流动力学上,异丙酚组收缩压和舒张压在术中和术后明显低于依托咪酯组(均P0.05);异丙酚组术后心率明显低于依托咪酯组(P0.05);同时,异丙酚组术中SpO2也明显低于依托咪酯组(P0.05)。异丙酚组总的不良反应发生率明显高于依托咪酯组(P0.05);其中低氧血症和注射痛在异丙酚组明显高于依托咪酯组(均P0.05);在体动和肌阵挛上,异丙酚组明显低于依托咪酯组(均P0.05)。然而,在内镜医师和麻醉医师满意度上,异丙酚组明显高于依托咪酯组(均P0.05)。结论在老年患者行无痛胃镜中,依托咪酯复合瑞芬太尼麻醉具有更稳定的血流动力学反应和较少的不良反应,值得在老年患者中推广。
[Abstract]:Objective to compare the effects of propofol and etomidate combined with remifentanil on the respiratory and circulatory system in elderly patients with painless gastroscopy. Propofol and etomidate combined with remifentanil were used in intravenous anesthesia and divided into propofol group (n = 200) and etomidate group (n = 200). Results there was no significant difference in the diagnostic results between the two groups (P 0.05). Etomidate group was earlier than propofol group in terms of hemodynamics. The systolic and diastolic blood pressure in propofol group was significantly lower than that in etomidate group during and after operation (all P 0.05), the heart rate in propofol group was significantly lower than that in etomidate group (P 0.05). SpO2 in propofol group was also significantly lower than that in etomidate group (P 0.05). The incidence of total adverse reactions in propofol group was significantly higher than that in etomidate group, and the incidence of hypoxemia and injection pain in propofol group was significantly higher than that in etomidate group (all P 0.05). Propofol group was significantly lower than etomidate group (all P 0.05). However, propofol group was significantly higher than etomidate group in the satisfaction of endoscope and anesthesiologist (P 0.05). Etomidate combined with remifentanil has a more stable hemodynamic response and fewer adverse reactions.
【作者单位】：重庆市中医院麻醉科;
【分类号】：R573

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