摘要
目的探讨应用异丙酚实施无痛胃肠镜检查的临床价值及体会。方法17630例患者由专职麻醉医师缓慢静脉注射异丙酚1.5～2.0mg/kg,待患者睫毛反射消失后即行胃肠镜检查,检查过程酌情追加异丙酚用量。观察患者入睡时间、苏醒时间,全程监测BP、HR、SPO2,记录如躁动、呛咳、呼吸抑制等不良反应及并发症,待患者清醒后询问遗忘程度及复诊率。结果除1例老年支气管炎急性期患者外,17629例患者均顺利完成胃肠镜检查。检查过程中患者血流动力学平稳,不良反应及并发症少,仅少数出现呼吸抑制(SPO2下降)、心律失常等,经处理后恢复正常。所有患者均在6分钟内苏醒,且对胃肠镜检查过程无记忆,自觉欣快舒适,乐于再次接受异丙酚实施无痛胃肠镜检查的有99.5%。结论应用异丙酚静脉全麻实施无痛胃肠镜检查是一种安全、舒适、有效的方法,值得临床推广应用。术前了解病史和体检,术中密切观察可减少不良反应,避免并发症。
Objective： To explore the value and the experience of using the propofol in painless gastroscopy.
Methods： 17 630 patients were injected with propofol at a slow speed about 1.5-2.0 mg/kg by the anaesthetist. While the eyeflash reflex was disappear, the gastroscopy was began. The dosage of the propofol would superadd if necessary during the examination. The sleeping time and the recovery time were observated.Not only, the BP, HR, SPO2 were monitored, but also the adversed reactions and the complications such as restlessness, choking, respiratory depression and ect. were recorded.The forgotten level and the rate of revisiting a doctor were asked after the patients came round, Results： 17 629 patients were accomplished successfully in the gastrocopy except one case that the elderly patient with acute bronchitis.During the examination, the hemodynamics in patients were stable and the complications and adversed reactions were few, only a small number of respiratory depression （SPO2 decline）, arrhythmia and ect. were occurred, but after the treatment they returned to normal. All the patients were awake in 6 minutes in average, and without memory, feeling consciously euphoric comfortable, and 99,5% of them were happy to accept the painless gastroscopy with propofol once again.
Conclusion： Painless gastroscopy with propofol can be characterized by advantages of salty comfort and reliability, and should be worth recommending.In addition, preoperative to realize the history and physical examination and to observed in close could reduce the adversed reactions and avoid the complications.
出处
《中国消化内镜》
2008年第3期24-26,共3页
Digestive Disease and Endoscopy
关键词
无痛
胃肠镜
异丙酚
Painless
Gastroscopy
Propofol
