摘要
目的观察在消化内镜治疗早期食管癌变中,分别予以芬太尼联合丙泊酚方案和咪达唑仑联合丙泊酚两种非气管插管麻醉方案的安全性及有效性。方法选择2010-01-01-2013-12-31于肥城市人民医院院接受消化内镜治疗的早期食管癌及其癌前病变患者138例,随机分为咪达唑仑+丙泊酚(68例,Ⅰ组)和芬太尼+丙泊酚静脉麻醉(70例,Ⅱ组)两组,比较两组患者在治疗过程生命体征的变化情况、不良反应发生率及术后快速恢复时间。结果两种麻醉方法均能顺利地完成手术。Ⅰ组方案进镜前即刻平均动脉压(简称血压)为(73.3±9.7)mm Hg,心率为(74.2±7.6)次/min;Ⅱ组方案进镜前即刻血压为(85.6±10.3)mm Hg,心率为(78.3±6.9)次/min。黏膜切除时Ⅰ组方案进镜前即刻血压为(80.6±12.1)mm Hg,心率为(77.3±6.9)次/min;Ⅱ组方案进镜前即刻血压为(87.7±13.2)mm Hg(1mm Hg=0.133kPa),心率为(79.4±7.2)次/min。冲水时Ⅰ组方案进镜前即刻血压为(78.6±11.7)mm Hg,心率为(75.5±7.8)次/min;Ⅱ组方案进镜前即刻血压为(75.5±7.8)mm Hg,心率为(78.7±8.3)次/min。Ⅰ组方案更能有效减少患者术中体动,χ2=3.19,P=0.07。快速恢复时间两组比较差异无统计学意义,P>0.05。少数患者有术中呛咳、一过性呼吸抑制及术后疼痛、恶心、头晕,但两组比较差异无统计学意义,P>0.05。结论咪达唑仑联合丙泊酚或芬太尼联合丙泊酚的静脉麻醉方案都是安全有效的,同时各自具备优势。
OBJECTIVE To assess the safety and effectiveness of two intravenous anesthesia methods in gastroen- doseopic treatment for precancerous lesions and early stage of esophageal cancer. METHODS A total of 138 patients with precancerous lesions and early stage of esophageal cancer were enrolled to undergo gastroendoscopic treatment in People＇s Hospital of Feicheng between Jan 1st, 2010 and Dec 31st,2013. All of them were randomized into two groups, with 68 patients in group I and 70 in group 11. Midazolam and propofol were used for group I , while fentanyl and propofol were used for group Ⅱ. Changes of vital signs, incidence rate of adverse reactions and post-operative recovery time were com- pared between the two groups. RESULTS All the patients in both groups had successfully undergone the operation. The blood pressure and heart rate of patients in group I fluctuated obviously and there were significant differences from those of group Ⅱ at some observation time points（P〈0.05）. The blood oxygen saturation of all patients in two groups was within normal range. The incidence of limb movements in group I was significantly lower than that of group Ⅱ （X2 = 3.19 ,P=0.07）, and no statistical significance was found between two groups in recovery time（P〉0.05）. A few patients had cough reaction and transient respiratory depression during the endoscopic therapy, and several, complained pain, nau- sea and dizziness after therapy, but there was no significant difference between two groups（P〉0.05）. CONCLUSION Propofol combined with midazolam or fentanyl used for intravenous anesthesia is safe and effective, and each has its ad- vantages.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2015年第13期1042-1045,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
国家科技支撑计划(200902002-8)
山东科技厅项目(2014GSF118022)
关键词
食管肿瘤
癌前病变
消化内镜
麻醉
治疗
esophagus neoplasms
precancerous lesion
gastroendoscope
anesthesia
therapy
