CAJ | 학술논문

目的：探讨一次麻醉行胃肠镜联合检查在老年患者中的可行性。方法45例麻醉下行联合胃肠镜检查的年龄≥65岁患者作为老年联合组，与92例分次检查的老年患者（老年分次组）和126例联合检查且年龄＜65岁的非老年患者（非老年联合组）进行对比。比较3组患者的基础疾病、术后苏醒时间、麻醉药用量、术中生命体征的变化以及不良反应发生率。结果老年联合组患者中高血压病及糖尿病的比例均高于非老年联合组（字2=10.254、9.164，P=0.001、0.002）。老年联合组的术后苏醒时间长于非老年联合组（t=1.098，P=0.009），但与老年分次组无统计学差异（t=-2.152，P=0.753）。老年联合组舒芬太尼及丙泊酚的用量均低于老年分次组和非老年联合组（t=-1.512、3.176，P=0.012、0.000）。老年联合组的生命体征异常变化发生率高于非老年联合组（字2=4.250，P=0.039），而与老年分次组之间无统计学差异（字2=0.572，P=0.449）。老年联合组其它不良反应发生率与老年分次组及非老年联合组比较均无统计学差异（字2=0.808、2.392，P=0.369、0.122）。结论一次麻醉行胃肠镜联合检查在老年患者中是可行的，但应掌握适应证，宜在麻醉内镜技术成熟以及监护、抢救设施齐全的医院开展。
목적：탐토일차마취행위장경연합검사재노년환자중적가행성。방법45례마취하행연합위장경검사적년령≥65세환자작위노년연합조，여92례분차검사적노년환자（노년분차조）화126례연합검사차년령＜65세적비노년환자（비노년연합조）진행대비。비교3조환자적기출질병、술후소성시간、마취약용량、술중생명체정적변화이급불량반응발생솔。결과노년연합조환자중고혈압병급당뇨병적비례균고우비노년연합조（자2=10.254、9.164，P=0.001、0.002）。노년연합조적술후소성시간장우비노년연합조（t=1.098，P=0.009），단여노년분차조무통계학차이（t=-2.152，P=0.753）。노년연합조서분태니급병박분적용량균저우노년분차조화비노년연합조（t=-1.512、3.176，P=0.012、0.000）。노년연합조적생명체정이상변화발생솔고우비노년연합조（자2=4.250，P=0.039），이여노년분차조지간무통계학차이（자2=0.572，P=0.449）。노년연합조기타불량반응발생솔여노년분차조급비노년연합조비교균무통계학차이（자2=0.808、2.392，P=0.369、0.122）。결론일차마취행위장경연합검사재노년환자중시가행적，단응장악괄응증，의재마취내경기술성숙이급감호、창구설시제전적의원개전。
Objective To evaluate the feasibility of gastroscopy and colonoscopy in one anesthetic session for elderly pa-tients. Methods Forty five elderly patients aged above 65 (elderly combination group) and 126 patients below 65 (non- elderly combination group) underwent gastroscopy and colonoscopy examinations in one anesthetic session and another 92 elderly pa-tients underwent gastroscopy and colonoscopy examinations separately (non- elderly combination group).The underlying dis-eases,palinesthesia time,dose of analgesics,changes of vital signs and incidences of other adverse reactions were monitored and recorded during procedures. Results In elderly combination group,more patients suffered from hypertension and diabetes than in non- elderly combination group (X2=10.254, P=0.001 andX2=9.164, P=0.002). Dosages of remifentanil and propofol in el-derly combination group were lower than those in non- elderly combination group(t=- 1.512, P=0.012 and t=3.176, P=0.000).The palinesthesia time was longer in elderly combination group than that in non- elderly combination group (t=1.098, P=0.009),but no difference was found between the elderly combination group and elderly non- combination group (t=- 2.152, P=0.753).The inci-dence of abnormal vital signs in elderly combination group was higher than that in non- elderly combination group (X2=4.250, P=0.039), but there was no difference compared to elderly non- combination group (X2=0.572, P=0.449).There were no signifi-cant differences in incidence of other adverse reactions among groups (X2=0.808, P=0.369; X2=2.392, P=0.122). Conclusion Gastroscopy and colonoscopy examinations in one anesthetic session are feasible for the elderly patients.