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[目的]探讨清醒镇静麻醉用于胃镜检查的效果。[方法]选取接受无痛胃镜检查术患者382例,162例高龄、肥胖、鼾症患者列为Ⅰ组,其他220例列为Ⅱ组。Ⅰ组患者用芬太尼复合地卡因胶浆,Ⅱ组患者常规使用丙泊酚+芬太尼。术中监测患者的误吸、低氧血症、术中体动、恶心呕吐、心律失常的发生率,术后监测患者头晕恶心呕吐的发生,并比较离院时间及麻醉费用。[结果]Ⅰ组的误吸、低氧血症及心率失常的发生率明显低于Ⅱ组(P<0.05),2组的术中体动、恶心呕吐的发生率比较则差异无统计学意义(P>0.05)。Ⅰ组术后的头晕、恶心呕吐发生率明显低于Ⅱ组(P<0.05),离院时间明显短于Ⅱ组(P<0.05),Ⅰ组因用药种类少,故麻醉费用少于Ⅱ组,2组比较差异有统计学意义(P<0.05)。[结论]清醒镇静麻醉方法用于高龄、肥胖及鼾症患者胃镜检查,安全有效,不适反应较轻,离院时间短,值得临床推广应用。
[Objective] To investigate the effect of conscious sedation anesthesia on gastroscopy. [Methods] 382 cases of painless gastroscopy, 162 elderly patients with obesity and snoring were selected as group Ⅰ, and the other 220 cases were classified as group Ⅱ. Patients in group I received fentanyl compound dexamethasone, and patients in group II received propofol + fentanyl routinely. Patients were monitored aspiration, hypoxemia, intraoperative physical activity, nausea and vomiting, the incidence of arrhythmia, postoperative monitoring of patients with dizziness and nausea and vomiting, and to compare the time of leaving hospital and anesthesia costs. [Results] The incidence of aspiration, hypoxemia and arrhythmia in group Ⅰ was significantly lower than that in group Ⅱ (P <0.05). There was no significant difference in the incidence of body movement and nausea and vomiting during operation between two groups (P> 0.05). The incidence of postoperative dizziness and nausea and vomiting in group Ⅰ was significantly lower than that in group Ⅱ (P <0.05), and the time to leave hospital was significantly shorter than that in group Ⅱ (P0.05). In group Ⅰ, the cost of anesthesia was less than that in group Ⅱ , The difference between the two groups was statistically significant (P <0.05). [Conclusion] The conscious and sedative anesthesia method is suitable for gastroscopy in elderly, obese and snoring patients. It is safe and effective, with less discomfort, shorter hospital stay and worthy of clinical application.