中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
8期
1013-1015
,共3页
李翔%张擎%朱俊杰%陈惠裕%潘学勤%范志宁
李翔%張擎%硃俊傑%陳惠裕%潘學勤%範誌寧
리상%장경%주준걸%진혜유%반학근%범지저
胃镜%依托咪酯%丙泊酚
胃鏡%依託咪酯%丙泊酚
위경%의탁미지%병박분
Gastroscopy%Elomidate%Propofol
目的 评价依托咪酯联合丙泊酚在胃镜检查中的麻醉诱导效果.方法 选择300例行无痛胃镜检查的患者,完全随机分为3组:丙泊酚组、依托咪酯联合丙泊酚组和依托咪酯组,每组100例,分别给予相应的麻醉药物.采用双盲法,单次给药,术中不再追加.给药后待睫毛反射消失,行胃镜检查,术中保留自主呼吸,面罩吸氧.记录给药前(T0)、给药后1 min时(T1)、苏醒时(T2)的心率、血压、呼吸频率；记录手术胃镜检查时间、苏醒时间及术中体动、呼吸暂停、低氧血症、心动过缓、低血压、肌阵挛及术后有关并发症的发生情况.结果 依托咪酯组患者麻醉苏醒时间短于丙泊酚组[(7.3±1.3)min比(9.1±2.0)min,P＜0.05].丙泊酚组患者T1时的SBP、DBP、心率、呼吸频率均较T0时降低[(94±16)mm Hg(1 mm Hg =0.133 kPa)比(115±17)mm Hg；(51±14)mm Hg比(63±16)mm Hg；(68±9)次/min比(78±11)次/min；(9.6±2.4)次/min比(18.5±3.1)次/min,均P＜0.05]；患者T2时的DBP、心率、呼吸频率与T1时比较,差异均有统计学意义[(57± 12)mm Hg 比(51±14)mm Hg； (75±7)次/min比(68±9)次/min；(13.9±2.6)次/min比(9.6±2.4)次/min,均P＜0.05].依托咪酯联合丙泊酚组患者T1时的心率和呼吸频率比T0时降低[(72±8)次/min比(79±9)次/min；(14.9±2.7)次/min比(18.6±2.1)次/min,均P＜0.05]；T2时的心率较T1时升高、较T0时降低,差异均有统计学意义[(76±8)次/min比(72±8)次/min；(76±8)次/min比(79±9)次/min,均p＜0.05].依托咪酯组患者T0、T1、T2时SBP、DBP、心率和呼吸频率分别两两比较,差异均无统计学意义(均P＞0.05).依托咪酯联合丙泊酚组患者T1时SBP与T0时SBP的差值(SBPT1-T0)要小于丙泊酚组患者的SBPT1-T0[(17±9)mm Hg 比(20±6)mm Hg,P＜0.05].3组患者不良反应例数分别为89、71、68例,两两比较差异无统计学意义(P＞0.05).结论 依托咪酯联合丙泊酚静脉麻醉用于无痛胃镜检查对呼吸和循环影响轻,术中及术后并发症发生率低.
目的 評價依託咪酯聯閤丙泊酚在胃鏡檢查中的痳醉誘導效果.方法 選擇300例行無痛胃鏡檢查的患者,完全隨機分為3組:丙泊酚組、依託咪酯聯閤丙泊酚組和依託咪酯組,每組100例,分彆給予相應的痳醉藥物.採用雙盲法,單次給藥,術中不再追加.給藥後待睫毛反射消失,行胃鏡檢查,術中保留自主呼吸,麵罩吸氧.記錄給藥前(T0)、給藥後1 min時(T1)、囌醒時(T2)的心率、血壓、呼吸頻率；記錄手術胃鏡檢查時間、囌醒時間及術中體動、呼吸暫停、低氧血癥、心動過緩、低血壓、肌陣攣及術後有關併髮癥的髮生情況.結果 依託咪酯組患者痳醉囌醒時間短于丙泊酚組[(7.3±1.3)min比(9.1±2.0)min,P＜0.05].丙泊酚組患者T1時的SBP、DBP、心率、呼吸頻率均較T0時降低[(94±16)mm Hg(1 mm Hg =0.133 kPa)比(115±17)mm Hg；(51±14)mm Hg比(63±16)mm Hg；(68±9)次/min比(78±11)次/min；(9.6±2.4)次/min比(18.5±3.1)次/min,均P＜0.05]；患者T2時的DBP、心率、呼吸頻率與T1時比較,差異均有統計學意義[(57± 12)mm Hg 比(51±14)mm Hg； (75±7)次/min比(68±9)次/min；(13.9±2.6)次/min比(9.6±2.4)次/min,均P＜0.05].依託咪酯聯閤丙泊酚組患者T1時的心率和呼吸頻率比T0時降低[(72±8)次/min比(79±9)次/min；(14.9±2.7)次/min比(18.6±2.1)次/min,均P＜0.05]；T2時的心率較T1時升高、較T0時降低,差異均有統計學意義[(76±8)次/min比(72±8)次/min；(76±8)次/min比(79±9)次/min,均p＜0.05].依託咪酯組患者T0、T1、T2時SBP、DBP、心率和呼吸頻率分彆兩兩比較,差異均無統計學意義(均P＞0.05).依託咪酯聯閤丙泊酚組患者T1時SBP與T0時SBP的差值(SBPT1-T0)要小于丙泊酚組患者的SBPT1-T0[(17±9)mm Hg 比(20±6)mm Hg,P＜0.05].3組患者不良反應例數分彆為89、71、68例,兩兩比較差異無統計學意義(P＞0.05).結論 依託咪酯聯閤丙泊酚靜脈痳醉用于無痛胃鏡檢查對呼吸和循環影響輕,術中及術後併髮癥髮生率低.
목적 평개의탁미지연합병박분재위경검사중적마취유도효과.방법 선택300례행무통위경검사적환자,완전수궤분위3조:병박분조、의탁미지연합병박분조화의탁미지조,매조100례,분별급여상응적마취약물.채용쌍맹법,단차급약,술중불재추가.급약후대첩모반사소실,행위경검사,술중보류자주호흡,면조흡양.기록급약전(T0)、급약후1 min시(T1)、소성시(T2)적심솔、혈압、호흡빈솔；기록수술위경검사시간、소성시간급술중체동、호흡잠정、저양혈증、심동과완、저혈압、기진련급술후유관병발증적발생정황.결과 의탁미지조환자마취소성시간단우병박분조[(7.3±1.3)min비(9.1±2.0)min,P＜0.05].병박분조환자T1시적SBP、DBP、심솔、호흡빈솔균교T0시강저[(94±16)mm Hg(1 mm Hg =0.133 kPa)비(115±17)mm Hg；(51±14)mm Hg비(63±16)mm Hg；(68±9)차/min비(78±11)차/min；(9.6±2.4)차/min비(18.5±3.1)차/min,균P＜0.05]；환자T2시적DBP、심솔、호흡빈솔여T1시비교,차이균유통계학의의[(57± 12)mm Hg 비(51±14)mm Hg； (75±7)차/min비(68±9)차/min；(13.9±2.6)차/min비(9.6±2.4)차/min,균P＜0.05].의탁미지연합병박분조환자T1시적심솔화호흡빈솔비T0시강저[(72±8)차/min비(79±9)차/min；(14.9±2.7)차/min비(18.6±2.1)차/min,균P＜0.05]；T2시적심솔교T1시승고、교T0시강저,차이균유통계학의의[(76±8)차/min비(72±8)차/min；(76±8)차/min비(79±9)차/min,균p＜0.05].의탁미지조환자T0、T1、T2시SBP、DBP、심솔화호흡빈솔분별량량비교,차이균무통계학의의(균P＞0.05).의탁미지연합병박분조환자T1시SBP여T0시SBP적차치(SBPT1-T0)요소우병박분조환자적SBPT1-T0[(17±9)mm Hg 비(20±6)mm Hg,P＜0.05].3조환자불량반응례수분별위89、71、68례,량량비교차이무통계학의의(P＞0.05).결론 의탁미지연합병박분정맥마취용우무통위경검사대호흡화순배영향경,술중급술후병발증발생솔저.
Objective The aim of this study was to evaluate the safty and the efficacy of etomidate combined with propofol for gastroscopy.Methods In a double-blind study,300 patients undergoing gastroscopy were randomly allocated into 3 groups.Propofol was used in Group A; etomidate combined with propofol were used in Group B and etomidate was used in Group C.Heart rate (HR),non-invasive blood pressure (NIBP)and respiratory rate(RR)were monitored and recorded before anesthesia(T0),one minute after anesthesia(T1)and the time of recovery(T2).The gastroscopy time and recovery time were calculated.In addition,the incidence of intraoperative body movement,apnea,hypoxemia,bradycardia,hypotension,myoclonus,injection pain and postoperative complications were also recorded.Results Compared with propofol group,the awakening time in etomidate group was significantly reduced[(7.3 ± 1.3)min vs(9.1 ±2.0)min,P＜0.05].In propofol group,compared with T0,systolic blood pressure(SBP),diastolic blood pressure(DBP),HR and RR in T1 were decreased significantly [(94 ± 16)mm Hg vs (115 ±17)mm Hg,(51 ± 14)mm Hg vs (63 ± 16)mm Hg,(68 ±9)/min vs(78 ± 11)/min,(9.6 ±2.4)/min vs (18.5 ±3.1)/min,all P＜0.05].However,compared with T1,DBP,HR and RR in T2 were increased significantly[(57 ± 12)mm Hg vs (51 ± 14)mm Hg,(75 ±7)/min vs(68 ±9)/min,(13.9 ±2.6)/min vs (9.6 ±2.4)/ min,all P ＜0.05].Compared with T0,HR and RR in T1 were significantly decreased In etomidate combined with propofol group[(72 ±8)/min vs(79 ±9)/min,(14.9 ±2.7)/min vs (18.6 ±2.1)/min,all P＜0.05],compared with T2,HR was decreased in T1 while increased in T0[(72 ±8)/min vs (76 ±8)/min,(79 ±9)/min vs (76 ± 8)/min,all P ＜0.05].In etomidate group,SBP,DBP,HR and RR were not effected in T0,T1,T2(P ＞0.05).The number of adverse reaction cases in three groups were 89、71 and 68 respectively.Conclusion Etomidate combined with propofol can be safer and more effective than each of them used alone in painless gastroscopy.
