30例无痛胃镜检查临床观察与体会

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目的:探讨无痛胃镜进行检查的临床意义,及可行性和安全性。方法:对我院30例胃镜检查患者随机分为观察组及对照组,观察组18例,麻醉时行静脉缓慢注射瑞芬太尼0.5μg~0.7μg/kg,然后再静脉缓慢注射丙泊酚(1.5~2)mg/kg,等待睫毛反射消失后行无痛胃镜检查。对照组12例,常规口服2%利多卡因胶浆10m L,给予咽部局部麻醉后进行胃镜检查。比较两组术前、术中的血压,心率,脉搏,血氧饱和度改变以及患者出现的不良反应。结果:观察组不良反应显著少于对照组,有显著统计学差异(P<0.05);对照组术前、术中,心率、收缩压及舒张压都上升,和检查前对比有统计学差异(P<0.05);观察组和对照组患者检查术前和术中心率、收缩压及舒张压、不良反应对比差异有统计学意义(P<0.05),有可比性。结论:丙泊酚联合瑞芬太尼静脉麻醉下进行无痛胃镜检查与普通胃镜检查相比更安全、更舒适,具有推广价值。 Objective: To investigate the clinical significance of painless gastroscopy for examination and its feasibility and safety. Methods: Thirty patients with gastroscopy in our hospital were randomly divided into observation group and control group. Eighteen patients in the observation group were given intravenous remifentanil 0.5 ~ 0.7 μg / kg intravenously while in the observation group. Then, propofol (1.5 ~ 2) mg / kg, waiting for eyelash reflex painless gastroscopy. Control group, 12 cases, 2% conventional oral lidocaine glue 10m L, given pharyngeal local anesthesia after gastroscopy. The preoperative and intraoperative blood pressure, heart rate, pulse rate, oxygen saturation and adverse reactions in patients were compared between the two groups. Results: The adverse reactions in the observation group were significantly less than those in the control group (P <0.05), and the control group had significant differences in preoperative, intraoperative, heart rate, systolic and diastolic blood pressure P <0.05). There were significant differences between the observation group and the control group in preoperative and intraoperative heart rate, systolic blood pressure and diastolic blood pressure, adverse reactions (P <0.05). Conclusion: Propofol combined with intravenous anesthesia with remifentanil for painless gastroscopy compared with conventional gastroscopy is safer and more comfortable, and has the promotion value.
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