作　　者： (付雄）;

机构地区： 四川省广元市第三人民医院麻醉科,四川广元628001

出　　处： 《实用医院临床杂志》 2017年第5期119-121,共3页

摘　　要： 目的探讨右美托咪定(DEX)复合丙泊酚用于无痛胃镜检查的临床效果及安全性。方法选择2016年1~6月在我院内窥镜室行胃镜检查的患者65例,按随机数字表法分为对照组(P组)33例和实验组(D组)32例,D组静脉推注DEX 0.1μg/(kg·min),P组缓慢静脉推注安慰剂(生理盐水)3 ml,之后两组均静脉推注丙泊酚2 mg/(kg·min),完成后开始插镜。记录术前(T0)、用DEX或安慰剂后(T1)、用丙泊酚后(T2),检查开始1 min(T3)、检查开始2 min(T4)、检查开始3min(T5)、检查结束时(T6)、可唤醒时(T7)等时点血氧饱和度(SpO_2)、平均动脉压(MAP)和心率(HR),并记录丙泊酚初始用量、总用量、胃镜操作时间、可唤醒时间、术中体动反应。结果 P组丙泊酚总用药量明显高于D组,D组发生体动例数明显少于P组(P<0.05)。T0、T1、T6及T7时,两组MAP差异无统计学意义(P>0.05);T2~T5时,D组MAP低于P组(P<0.05)。两组间HR、SpO_2在各时间点比较差异均无统计学意义(P>0.05)。结论小剂量DEX在无痛胃镜中的使用方法简单,且具有良好的安全性;能协同丙泊酚的麻醉镇静作用,提供更佳的术中镇静效果。 Objective To evaluate the clinical efficacy and safety of dexmedetomidine （DEX） combined with propofol in painless gastroscopy. Methods Sixty-five patients undergoing gastroscopic examination during period of January to June 2016 in our hospital endoscope room were randomly divided into control group （group P, n = 33） and experimental group （group D, n = 32）. The group D received intravenous injection of DEX 0. 1 （ g/ （ kg min） while the group P was intravenously given placebo saline 3 ml. The two groups had intravenous injection of propofol 2 mg/ （ kg min） after the start of insertion. The oxygen saturation （ SpO2 ）, mean arterial pressure （MAP） and heart rate （HR） before operation （ T0）, at administration of DEX or placebo （T1）, propofol （T2）, at examination start 1 rnin （ T3 ）, start 2 min （T4）, start 3 min （ T5 ） and at the end （ T6 ） of examination as well as wake-up （ T7 ） were recorded. The total propofol dosage, initial dosage, gastroscopy operation time, wake-up time and intraoperative body movement were also recorded. Results The total dose of propofol in the group P was significantly higher than that in the group D, and the number of body movement in the group D was significantly less than that in the group P （P 〈 0. 05 ）. At the TO, T1, T6 and T7, there was no sig- nificant difference in MAP between the two groups （P 〉 0. 05）. At the T2 - T5, MAP was lower in the group D than that in the group P （P 〈 0. 05 ）. The difference in HR and SpO2 between the two groups at any time point was not statistically significant （P 〉 0.05 ）. Conclusion The use of low-dose DEX in painless gastroscopy is simple and safe. It can be combined with propofol anesthesia and se- dation, and provide better sedative effect during the gastroscopy operation.

关 键 词： 右美托咪定 丙泊酚 无痛胃镜