摘要
目的 使结肠镜检查更加顺利 ;比较两种方法的优缺点 ,使镇静镇痛技术在结肠镜检查中更有选择性。方法 共 30 2人进行了结肠镜检查 ,分为MF组 (咪唑安定 +芬太尼n =90 ) ,MP组 (咪唑安定 +异丙酚n =16 2 ) ,普通对照 (n =5 0 )。MF组镜检前予咪唑安定 1～ 2mgiV ,芬太尼 5 0mgim ;MF组镜检前予咪唑安定 1～ 1.5mgiV ,异丙酚 0 .5～ 2 .0mg/KgiV (Range 2 5～ 14 5mg) ,直到患者进入浅睡眠状态 ,睫毛反射消失 ,呼吸平稳后 ,开始进行肠镜检查或治疗 ;对照组未给予任何药物。检查时均给予吸氧。结果 MF组、MP组均取得了良好的镇静镇痛效果 ,MP组作用更显著 (P <0 .0 0 1) ;MF组记忆缺失率明显低于异丙酚组 ;MP组与其他两组相比 ,其对脉搏的影响有显著差异 (P <0 .0 5 ) ,对血压的影响有显著差异 (P <0 .0 0 1) ,影响血压严重改变发生率有显著差异 (P <0 .0 0 1)。三组之间对SPO2 的影响无差别。MF组与对照组相比 ,对Bp、P、SPO2 的影响无差别。结论 咪唑安定联合芬太尼 /异丙酚均有良好的镇静镇痛效果。咪唑安定联合芬太尼更适用于有心血管疾患的病人 ;
Objective:To making colonoscopy more smooth; to compare the efficacy of two kinds of methods,make sedation and anesthesia have the ahemative for easy colonoscopy. Methods:Three hundred and two cases were included in this study, the patients were randomized into three groups-MF group ( midazolam and fentanyl group n = 90), MP group ( midazolam and propofol group n = 162), contrast group ( no sedative was employed prior to intubation n =50 ). MF group with midazolam 1～2 mg iv plus fentanyl 50 mg im before the procedure, MP group with midazolam 1～1.5 mg iv plus propofol 0. 5 ～2.0 mg/kg iv) (Range 25～145 mg). Heart rate, blood pressure and SPO 2 were obtained for each patient before the procedure and monitored continuously during and after tile procedure. Results:Data in MF group and MP group showed high satisfaction with sedation and anesthesia, specially in MP group (P<0.001). Amnesia in MP groups were significant different from MF group. There were significant change of pulse and blood pressure in MP (P<0.001). Clinical impotant changes in blood pressure were most frequently noted.Conclusions:Both of the two methods can produce safe and effective sedation and anesthesia for colonoscopy. Midazolam combine fentanyl appears to decrease the risk of cardiac complications, yet midazolam combine propofol appears more effective in seriously nervous patients.
出处
《中国内镜杂志》
CSCD
2003年第11期7-9,共3页
China Journal of Endoscopy
