摘要
目的 探讨老年患者静脉麻醉下行胃肠镜检查的安全性分析.方法 选择130例行胃肠镜检查患者,按年龄分为老年人组（A组）：65～75岁,65例;年轻人组（B组）：30～〈65岁,65例.在应用相同芬太尼联合丙泊酚静脉麻醉下,分析两组的生命体征（包括心率、血压、血氧饱和度）、麻醉时间、意识恢复时间、用药量、患者感受及不良反应发生情况.结果 （1）静脉麻醉后,两组血压、心率在不同程度上均有所下降,但两组检查前与检查中时间点比较,A组差异均无统计学意义（t=0.11、0.67、0.73,均P〉0.05）,B组差异均无统计学意义（t=0.27、0.83、1.82,均P〉0.05）;在术中,A组出现1例心率降至50次/min以下,B组出现1例心率降至50次/min以下的;A组有1例SBP下降达检查前基础血压的30％,B组没有出现SBP下降达检查前基础血压的30％病例.静脉麻醉对老年患者SpO2影响较大,且随着年龄增长,其发生率增高,予以对症处理后,SpO2立即回升,并顺利完成检查.（2）A组麻醉时间为（16.75±5.76）min、意识恢复时间为（3.51±0.69）min,丙泊酚用药量为（72.43±19.58）mg,B组麻醉时间为（15.96±6.58）min、意识恢复时间为（2.98±0.71）min,丙泊酚用药量为（71.67±20.49）mg,两组比较差异均无统计学意义（t=1.85、1.57、1.96,均P〉0.05）,但A组用药量比B组多,说明随年龄增长,用药量反而减少.（3）两组患者静脉麻醉下行胃肠镜检查均能达到麻醉镇静效果满意,顺利安全的完成检查.且未发生出血、穿孔甚至死亡等严重不良后果.结论在严格控制适应证及严密观察下,老年患者静脉麻醉下行胃肠镜检查同样是安全、舒适、可行的.
Objective To investigate the safety of gastrointestinal endoscopy in elderly patients undergoing intravenous anesthesia .Methods 130 patients undergoing gastrointestinal endoscopy were selected .The patients were divided into the elderly group （ A group）：65 to 75 years old,65 cases,and young group （ B group）：30 to 65 years old,65 cases.The vital signs （ including heart rate, blood pressure, blood oxygen saturation ）, anesthesia time, consciousness recovery time,dosage, patients ＇experience and adverse reaction were analyzed in the same group of fentanyl combined with propofol intravenous anesthesia .Results （1）Intravenous anesthesia,the blood pressure,heart rate of the two groups decreased in varying degrees ,compared between before examination and during examination in the two groups,there were no statistically significant differences in A group （t=0.11,0.67,0.73,all P〉0.05）,and there were no statistically significant differences in B group （t =0.27,0.83,1.82,all P〉0.05）.In the surgery, 1 case of heart rate dropped to 50 times/min below in A group and B group;In A group,1 case of SBP decreased by 30％ of baseline blood pressure before examination ,and B group did not show 30％reduction in SBP before reaching baseline blood pressure .Intravenous anesthesia had greater impact on SpO 2 in elderly patients , and with age increased,the incidence increased, after symptomatic treatment, SpO2 immediately rebounded, and successfully completed the inspection.（2）In A group,the anesthesia time was （16.75 ±5.76）min,the conscious recovery time was （3.51 ±0.69）min,the propofol dosage was （72.43 ±19.58）mg.In B group,the anesthesia time was （15.96 ± 6.58）min,conscious recovery time was （2.98 ±0.71）min,the propofol dosage was （71.67 ±20.49）mg,there were no statistically significant differences between the two groups （t=1.85,1.57,1.96,all P〉0.05）,but the amount of A group was more than that of B group,indicated that with age increased,the dosage decreased.（3）The patients of the two groups underwent intravenous anesthesia under the gastrointestinal endoscopy could achieve satisfactory anesthesia sedative effect ,and safe to complete the examination .And no bleeding ,perforation and even death and other serious adverse consequences were observed .Conclusion In the strict control of indications and close observation , elderly patients undergoing anesthesia under the gastrointestinal endoscopy is safe ,comfortable and feasible .
作者
郑彩虹
李洋
Zheng Caihong;Li Yang(Department of Anesthesiology,the Obstetrics and Gynecology Hospital of Hangzhou ,Hangzhou, Zhejiang 310053, China;Department of Anesthesiology, Zhefiang Greentown Cardiovascular Hospital, Hangzhou, Zhejiang 310008, China)
出处
《中国基层医药》
CAS
2018年第4期511-514,共4页
Chinese Journal of Primary Medicine and Pharmacy
