摘要
目的探讨无痛技术在结肠镜检查中的安全性及其对检查效果的影响。方法由同一个高年资医生完成的806例结肠镜检查患者,其中398例采用丙泊酚+芬太尼静脉麻醉,408例行普通结肠镜检查,观察两组病例检查前、插镜时、检查开始后5 min、术毕共四个时点的HR、收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、SpO2、呼吸频率(RR)。记录两组肠镜检查达盲率、达盲时间、总检查时间、疾病检出率、无痛组丙泊酚及芬太尼用量、术中特殊用药、和术毕恶心、呕吐及腹胀不良反应等资料,以及术毕进行能否再次接受肠镜检查的调查。结果两组患者检查前心率、血压、血氧饱和度无显著差异(P> 0.05)。插镜时、开始检查后5 min及术毕,无痛组心率、血压均较术前下降,而常规组均较术前上升,差异有统计学意义(P <0.05)。在插镜时、开始检查后5 min及术毕三个时点两组间比较,无痛组心率、血压、血氧饱和度均低于普通组,差异有统计学意义(P<0.05)。无痛肠镜组达盲率98.24%、疾病检出率70.85%,普通组达盲率93.14%、疾病检出率64.95%,差异有统计学意义(P <0.05);无痛组拒绝再次检查者0.75%,普通组21.08%,差异有统计学意义(P <0.05);两组均未出现严重并发症。结论无痛电子结肠镜是一种较安全的检查方法,能提高患者舒适度、达盲率和疾病检出率。
Objective To assess the effect and safety of painless technique on colonoscopy. Methods 806 cases which are operated by the same Senior surgeon are devided into 2 groups: painless group(398 patients accepted propofol-fentanyl intravenous anesthesia before colonoscopy) and normal group(408 cases checked conventionally). The heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP), mean arterial pressure(MAP),Sp O2 and respiratory rate(RR) of patients before the examination, the time of insertion, 5 minutes later and at the end time were observed. Success rate and time cost of reaching the ileocecal junction, total examination time, rate of illness detection, dose of propofol and fentanyl in painless group, special medication during operation, adverse reactions such as nausea, vomiting and abdominal distention after operation were recorded. A survey of whether to do enteroscopy again was investigated after the operation. Results There was no significant difference in HR,Bp,Sp O2 and RR between the two groups before examination. The HR, Bp,Sp O2 and RR of the painless group at the time of insertion, 5 minutes after insertion and at the end of the examination were lower than before operation, while in the normal group were higher than before operation. The HR, Bp and SpO2 of painless group at the time of insertion, 5 minutes after insertion and at the end of the examination were significantly lower than normal group(P < 0.05). The success rate of reaching the ileocecal junction and illness detection rate in painless group was 93.14% and 70.85%,which was significantly higher than normal group(P < 0.05). 0.75% in painless group would not accept enteroscopy again, which was significantly lower than normal group(P < 0.05).No serious complications occurred in both groups. Conclusion Painless techniquec,which can siginificantly improve patients’ comfort and success rate of examination, is safe and worth to be applied in the clinical application of colonoscopy.
作者
王飞
张洪印
刘汉博
李跃祥
WANG Fei;ZhANG Hong-yin;LIU Han-bo(Department of Anesthesiology,Tianjin Xiqing Hospital,Tianjin 300380,China;Department of general surgery,Tianjin Xiqing Hospital,Tianjin 300380,China)
出处
《中国处方药》
2020年第4期163-165,共3页
Journal of China Prescription Drug
