CAJ | 학술논문

目的：观察右美托咪定复合小剂量氯胺酮用于肠镜下治疗的安全性及可行性。方法选取需行肠镜下治疗患者60例，随机分为2组，每组30例。其中D组患者使用右美托咪定复合氯胺酮麻醉；P组患者使用异丙酚复合芬太尼麻醉。观察并记录2组患者注药前（ T1）、置入肠镜（ T2）、操作结束（ T3）、苏醒（ T4）等时点的MAP、HR、SPO2，以及操作总时间（ T）和完全清醒需要的时间（ Tw ）；记录有无低血压、缓慢心率、呼吸抑制等不良反应。结果 D组患者术前、术中、术后、苏醒时MAP、HR、SPO2变化较P组平稳，且完全清醒时间要短于P组，低血压、缓慢心率和呼吸抑制发生率也要低于P组，2者比较差异均有差异性（ P值均小于0.05）。结论对于肠镜下治疗需要较长时间镇静麻醉的手术，使用右美托咪定复合小剂量氯胺酮可以稳定患者术中的生命体征，且苏醒时间和苏醒质量优于异丙酚复合阿片麻醉，是一种比较安全理想的麻醉方式。
목적：관찰우미탁미정복합소제량록알동용우장경하치료적안전성급가행성。방법선취수행장경하치료환자60례，수궤분위2조，매조30례。기중D조환자사용우미탁미정복합록알동마취；P조환자사용이병분복합분태니마취。관찰병기록2조환자주약전（ T1）、치입장경（ T2）、조작결속（ T3）、소성（ T4）등시점적MAP、HR、SPO2，이급조작총시간（ T）화완전청성수요적시간（ Tw ）；기록유무저혈압、완만심솔、호흡억제등불량반응。결과 D조환자술전、술중、술후、소성시MAP、HR、SPO2변화교P조평은，차완전청성시간요단우P조，저혈압、완만심솔화호흡억제발생솔야요저우P조，2자비교차이균유차이성（ P치균소우0.05）。결론대우장경하치료수요교장시간진정마취적수술，사용우미탁미정복합소제량록알동가이은정환자술중적생명체정，차소성시간화소성질량우우이병분복합아편마취，시일충비교안전이상적마취방식。
Objective To investigate the safety and feasibility of dexmedetomidine ( DEX) combined with small doses of ketamine used for treatment under colonoscopy .Methods A total of 60 patients were randomly divided into two groups .The patients in group D received vein anesthesia using DEX combined with katemine during the treatment under colonoscopy while those in group P received vein anesthesia using propofol combined with fentanyl .The respiratory and circulation indices , and adverse effects were observed and compared between the two groups .Results The respiratory and circulation fluctuation in group D were significantly smoother than those in group P (P<0.05),and the adverse effect was lower in group D than that in group P.Conclusion The vein anesthesia using DEX combined with small doses of ketamine used for treatment under colonoscopy is safe and feasible ,which is better for patients with instability of circulation .