中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2014年
6期
37-39
,共3页
胡辉%荆绪斌%邹细岩%吴锦雄
鬍輝%荊緒斌%鄒細巖%吳錦雄
호휘%형서빈%추세암%오금웅
胆石%清醒镇静%麻醉%内窥镜
膽石%清醒鎮靜%痳醉%內窺鏡
담석%청성진정%마취%내규경
Gallstones%Conscious sedation%Anesthesia%Endoscopes
目的 探讨清醒镇静与静脉麻醉在内窥镜逆行胰胆管造影术(ERCP)治疗肝外胆管结石中的安全性、有效性.方法 将100例采用ERCP治疗的肝外胆管结石患者按入组顺序进行编号,50例奇数者采用静脉麻醉(静脉麻醉组),给予静脉注射丙泊酚；50例偶数者采用清醒镇静(清醒镇静组),给予肌肉注射地西泮及哌替啶.观察两组患者术中反应(拔镜行为、自行体位改变)、生命体征变化情况、操作时间、取石成功率及并发症发生情况.结果 清醒镇静组术中拔镜行为、自行体位改变发生率明显高于静脉麻醉组[24％(12/50)比2％(1/50)、18％(9/50)比0],差异均有统计学意义(P＜0.01).两组用药后5min平均动脉压、心率均较术前明显降低,差异有统计学意义(P＜0.05)；进镜后10 min、术后清醒时与术前比较差异无统计学意义(P＞0.05)；两组脉搏血氧饱和度比较差异均无统计学意义(P＞0.05).两组取石成功率均为98％(49/50).静脉麻醉组操作时间明显短于清醒镇静组[(38.2±6.3) min比(49.1±9.9) min],差异有统计学意义(P＜0.01).两组并发症发生率比较差异无统计学意义(P＞0.05).结论 静脉麻醉和清醒镇静均可用于ERCP治疗肝外胆管结石,但静脉麻醉能明显减轻患者不适,缩短操作时间.
目的 探討清醒鎮靜與靜脈痳醉在內窺鏡逆行胰膽管造影術(ERCP)治療肝外膽管結石中的安全性、有效性.方法 將100例採用ERCP治療的肝外膽管結石患者按入組順序進行編號,50例奇數者採用靜脈痳醉(靜脈痳醉組),給予靜脈註射丙泊酚；50例偶數者採用清醒鎮靜(清醒鎮靜組),給予肌肉註射地西泮及哌替啶.觀察兩組患者術中反應(拔鏡行為、自行體位改變)、生命體徵變化情況、操作時間、取石成功率及併髮癥髮生情況.結果 清醒鎮靜組術中拔鏡行為、自行體位改變髮生率明顯高于靜脈痳醉組[24％(12/50)比2％(1/50)、18％(9/50)比0],差異均有統計學意義(P＜0.01).兩組用藥後5min平均動脈壓、心率均較術前明顯降低,差異有統計學意義(P＜0.05)；進鏡後10 min、術後清醒時與術前比較差異無統計學意義(P＞0.05)；兩組脈搏血氧飽和度比較差異均無統計學意義(P＞0.05).兩組取石成功率均為98％(49/50).靜脈痳醉組操作時間明顯短于清醒鎮靜組[(38.2±6.3) min比(49.1±9.9) min],差異有統計學意義(P＜0.01).兩組併髮癥髮生率比較差異無統計學意義(P＞0.05).結論 靜脈痳醉和清醒鎮靜均可用于ERCP治療肝外膽管結石,但靜脈痳醉能明顯減輕患者不適,縮短操作時間.
목적 탐토청성진정여정맥마취재내규경역행이담관조영술(ERCP)치료간외담관결석중적안전성、유효성.방법 장100례채용ERCP치료적간외담관결석환자안입조순서진행편호,50례기수자채용정맥마취(정맥마취조),급여정맥주사병박분；50례우수자채용청성진정(청성진정조),급여기육주사지서반급고체정.관찰량조환자술중반응(발경행위、자행체위개변)、생명체정변화정황、조작시간、취석성공솔급병발증발생정황.결과 청성진정조술중발경행위、자행체위개변발생솔명현고우정맥마취조[24％(12/50)비2％(1/50)、18％(9/50)비0],차이균유통계학의의(P＜0.01).량조용약후5min평균동맥압、심솔균교술전명현강저,차이유통계학의의(P＜0.05)；진경후10 min、술후청성시여술전비교차이무통계학의의(P＞0.05)；량조맥박혈양포화도비교차이균무통계학의의(P＞0.05).량조취석성공솔균위98％(49/50).정맥마취조조작시간명현단우청성진정조[(38.2±6.3) min비(49.1±9.9) min],차이유통계학의의(P＜0.01).량조병발증발생솔비교차이무통계학의의(P＞0.05).결론 정맥마취화청성진정균가용우ERCP치료간외담관결석,단정맥마취능명현감경환자불괄,축단조작시간.
Objective To evaluate the safety and effectiveness of conscious sedation and intravenous anesthesia used to endoscopic retrograde cholangio pancreatiography (ERCP) in treatment of extrahepatic bile duct stones.Methods A total of 100 cases of extrahepatic bile duct stones patients in treatment of ERCP were encoded by the group order,50 cases of odd used intravenous anesthesia (intravenous anesthesia group),intravenous injection of propofol; 50 cases of even used conscious sedation (conscious sedation group),muscle injection of diazepam and pethidine.Intraoperative reaction (extubation behavior,own postural changes),changes in vital signs,operating time,the success rate of stone and complication were observed in two groups.Results The incidence of intraoperative extubation behavior and own postural changes in conscious sedation group were significantly higher than those in intravenous anesthesia group [24％ (12/50) vs.2％ (1/50),18％ (9/50) vs.0],and the differences were statistically significant (P ＜ 0.01).The heart rate and mean artery pressure in two groups were decreased at 5 minutes after administration than that before operation,and the difference was statistically significant (P ＜ 0.05),but there was no statistical significance at 10 min after entering the mirror and postoperative awake compared with before operation (P ＞ 0.05).Pulse oxygen saturation between two groups had no statistical significance (P ＞0.05).The success rate of stone in two groups were 98％ (49/50).Operating time in intravenous anesthesia group was obviously shorter than that in conscious sedation group [(38.2 ± 6.3) min vs.(49.1 ± 9.9) min] (P ＜ 0.01).The complications between two groups had no statistical significance (P ＞ 0.05).Conclusion Conscious sedation and intravenous anesthesia can be used to ERCP in treatment of extrahepatic bile duct stones,but intravenous anesthesia can obviously reduce patients discomfort,shorten the operation time.
