CAJ | 학술논문

目的：观察低剂量咪唑安定联合芬太尼在肥胖患者胃镜检查中的临床效果，并评估其安全性。方法选择本院2012年6月～2013年12月收治的需行胃镜检查的肥胖患者200例作为研究对象，按照数字随机法分组，每组100例，对照组采取咽部喷雾利多卡因局麻，观察组于局麻基础上采取低剂量咪唑安定联合芬太尼，观察比较2组临床效果。结果2组麻醉前生命体征相关指标心率（HR）、平均动脉压（MAP）及4个不同时间SPO2均无明显差异（P＞0．05），麻醉后（T2）、进镜1 min（T3）、手术结束时（T4）观察组HR、MPP均较对照组更加平稳（P＜0．05）；观察组患者术后对胃镜检查感受舒适67例、尚可27例、不适5例、难受1例，明显优于对照组（P＜0．05）；观察组出现恶心、呕吐5例（5．0％），咳嗽7例（7．0％），躁动3例（3．0％），呃逆4例（4．0％），不良反应发生率19例（19．0％），明显低于对照组46例（46．0％），P＜0．05。结论低剂量咪唑安定联合芬太尼在肥胖患者胃镜检查中的临床效果较佳，不良反应少，较为安全。
목적：관찰저제량미서안정연합분태니재비반환자위경검사중적림상효과，병평고기안전성。방법선택본원2012년6월～2013년12월수치적수행위경검사적비반환자200례작위연구대상，안조수자수궤법분조，매조100례，대조조채취인부분무리다잡인국마，관찰조우국마기출상채취저제량미서안정연합분태니，관찰비교2조림상효과。결과2조마취전생명체정상관지표심솔（HR）、평균동맥압（MAP）급4개불동시간SPO2균무명현차이（P＞0．05），마취후（T2）、진경1 min（T3）、수술결속시（T4）관찰조HR、MPP균교대조조경가평은（P＜0．05）；관찰조환자술후대위경검사감수서괄67례、상가27례、불괄5례、난수1례，명현우우대조조（P＜0．05）；관찰조출현악심、구토5례（5．0％），해수7례（7．0％），조동3례（3．0％），애역4례（4．0％），불량반응발생솔19례（19．0％），명현저우대조조46례（46．0％），P＜0．05。결론저제량미서안정연합분태니재비반환자위경검사중적림상효과교가，불량반응소，교위안전。
Objective To observe the clinical effect of low dose of midazolam combined with fentanyl in gastroscopy examination for patients of obesity ,and to evaluate its safety .Methods We selected 200 cases of patients of obesity who need gastroscopy treat‐ment in our hospital from June 2012 to December 2013 as the research objects .The patients were divided into two groups accord‐ing to random number table with 100 cases in each group .The control group accepted the pharyngeal spraying lidocaine local anes‐thesia ,while the observation group adopted low dose midazolam combined with fentanyl on the basis of local anesthesia .Results The two groups′heart rate (HR) ,mean arterial pressure (MAP) and four different time of SPO2 showed no significantly different be‐fore anesthesia (P>0 .05) .The HR ,MPP after anesthesia (T2 ) ,1 min (T3 ) after the mirror entering and the end of operation (T4 ) for observation group were more stable (P< 0 .05);In the observation group ,patients felt comfortable 67 cases ,fair 27 ca‐ses ,discomfort 5 cases ,pain 1 case ,which was significantly better than the control group (P<0 .05);In the observation group nausea ,vomiting 5 cases (5 .0% ) ,cough 7 cases (7 .0% ) ,agitation 3 cases (3 .0% ) ,hiccup 4 cases (4 .0% ) ,the total incidence of adverse reactions was 19 cases (19 .0% ) , significantly lower than the control group of 46 cases (46 .0% ) ( P< 0 .05 ) . Conclusion Low dose midazolam combined with fentanyl in obese patients has a better clinical effect and less adverse reaction com‐pared with the control group .