【摘 要】
：
目的:研究丙泊酚镇静下无痛胃镜检查过程中,患者的低氧血症发生率及其危险因素,为制定临床预防策略提供理论依据.方法:2017年11月至2018年2月,连续纳入共1000例行丙泊酚镇静
【机 构】
：
上海交通大学医学院附属仁济医院麻醉科,上海 200127
论文部分内容阅读
目的:研究丙泊酚镇静下无痛胃镜检查过程中,患者的低氧血症发生率及其危险因素,为制定临床预防策略提供理论依据.方法:2017年11月至2018年2月,连续纳入共1000例行丙泊酚镇静下无痛胃镜检查的门诊患者,记录术中是否发生低氧血症及镇静相关不良事件.将患者分为发生低氧血症和未发生低氧血症2组,记录患者的基本资料和无痛胃镜检查及麻醉的相关信息.结果:1000例患者行丙泊酚镇静下无痛胃镜检查过程中,低氧血症发生率为8.4％,有高血压病史、打鼾史、年龄大、体质量指数(body mass index,BMI)高、美国麻醉医师协会(Ameri-can Society of Anesthesiologists,ASA)分级高、甲颏距离小、胃镜进镜次数多、丙泊酚总用量大和基础血氧饱和度低是其发生低氧血症的危险因素(P＜0.05),其中年龄大(45～65岁,OR=2.903,95％CI为1.399～6.026;＞65岁,OR=5.495,95％CI为2.124～14.211);丙泊酚总用量大(80～100 mg,OR=3.289,95％CI为1.215～8.906;101～120 mg,OR=5.881,95％CI为1.964～17.615;＞120 mg,OR=7.717,95％CI为2.664～22.351);基础血氧饱和度低(＜95％,OR=3.327,95％CI为1.173～9.439)是无痛胃镜检查过程中发生低氧血症的独立危险因素.结论:老年患者(＞65岁)、丙泊酚总用量较大(＞120 mg)以及术前基础血氧饱和度低(＜95％)的患者,在无痛胃镜检查过程中发生低氧血症的风险增高,医师应积极主动对其进行预防和干预.
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