CAJ | 학술논문

目的：评价丙泊酚联合盐酸右美托咪定应用于无痛单气囊小肠镜检查的安全性及有效性。方法：将60例拟行无痛单气囊小肠镜检查的患者随机分为丙泊酚组（A 组）和丙泊酚复合盐酸右美托咪定组（B 组）。观察操作前、睫毛反射消失时、小肠镜经过回盲部和检查结束时的平均动脉压（MAP）、呼吸频率（RR）、心率（HR）和血氧饱和度（SPO2），诱导时间，苏醒时间和丙泊酚使用总量，术中出现体动、心动过缓、呼吸暂停/抑制，术后出现恶心呕吐和反映术中出现梦境/知晓等不良反应以及患者满意度。结果：所有患者均能顺利完成检查，诱导入睡后 A 组 MAP 明显下降（P ＜0．05），B 组 HR 亦明显减低（P ＜0．05）。两组RR、SPO2、诱导时间、苏醒时间、满意度无统计学差异。丙泊酚的总用量 B 组明显少于 A 组（P ＜0．05），镇静评分优于 A 组（P ＜0．05）。 B 组出现体动、呼吸暂停/抑制的不良反应明显少于 A 组，但心动过缓发生率有所增高（P ＜0．05）。结论：丙泊酚复合盐酸右美托咪定适用于无痛单气囊小肠镜检查，能节约丙泊酚用量及减少不良反应发生，是一种安全有效的检查方法。
목적：평개병박분연합염산우미탁미정응용우무통단기낭소장경검사적안전성급유효성。방법：장60례의행무통단기낭소장경검사적환자수궤분위병박분조（A 조）화병박분복합염산우미탁미정조（B 조）。관찰조작전、첩모반사소실시、소장경경과회맹부화검사결속시적평균동맥압（MAP）、호흡빈솔（RR）、심솔（HR）화혈양포화도（SPO2），유도시간，소성시간화병박분사용총량，술중출현체동、심동과완、호흡잠정/억제，술후출현악심구토화반영술중출현몽경/지효등불량반응이급환자만의도。결과：소유환자균능순리완성검사，유도입수후 A 조 MAP 명현하강（P ＜0．05），B 조 HR 역명현감저（P ＜0．05）。량조RR、SPO2、유도시간、소성시간、만의도무통계학차이。병박분적총용량 B 조명현소우 A 조（P ＜0．05），진정평분우우 A 조（P ＜0．05）。 B 조출현체동、호흡잠정/억제적불량반응명현소우 A 조，단심동과완발생솔유소증고（P ＜0．05）。결론：병박분복합염산우미탁미정괄용우무통단기낭소장경검사，능절약병박분용량급감소불량반응발생，시일충안전유효적검사방법。
Objective: To observe the clinical safety and effectiveness of anaesthetic drugs propofol combined with dexmedetomidine in painless single-balloon enteroscopy examination.Methods: 60 patients,scheduled for painless single-balloon enteroscopy examination were randomly divided into two groups:propofol group (group A,n =30) and propofol combined with dexmedetomidine group (group B, n =30).The blood pressure(MAP),respiratory rate(RR),heart rate(HR),blood oxygen saturation (SPO2 ), induction time,recovery time,total propofol dosage of two groups were observed during the examination(before the operation,when the eyelash reflex,when en-teroscopy and inspection after the end of the ileocecal.).Adverse reactions such as body movements,bradycardia,apnea/respiratory de-pression,awareness of intraoperative and nausea, vomitting, satisfaction of postoperative were recorded.Results: All patients had comple-ted the examination successfully.MAP of group A and HR of group B were decreased significantly after anesthesia induction(P <0.05). There had no statistical significance in the perioperative RR,SPO2 ,induction time,recovery time and satisfaction of two groups( P >0.05).Total propofol dosage of group B were significantly less than group A and ramsay score of group B were better than group A.Adverse reactions such as body movements,apnea/respiratory depression of group B were significantly less than group A, but bradycar-dia rate increased(P <0.05).Conclusion: Propofol combined with dexmedetomidine which save the total propofol dosage and reduce the adverse reaction can provide a safe and effective means in single-balloon enteroscopy examination.