摘要
目的探讨酮咯酸氨丁三醇联合丙泊酚对老年患者无痛胃镜检查术血流动力学及应激反应的影响。方法按照随机数字表法将120例需进行无痛胃镜检查的患者分为观察组(酮咯酸氨丁三醇联合丙泊酚组)和对照组(单纯丙泊酚组),每组各60例。最终入选观察组58例、对照组59例。检测两组患者麻醉前(T0)、置入胃镜时(T1)、术毕(T2)血清中血糖(BG)、肾上腺素(E)、皮质醇(Cor)的含量并记录两组患者各时间点MAP、HR、SPO2的变化;记录两组患者丙泊酚用量、术后清醒时间并对麻醉效果进行评价;观察并记录术中病人出现的不良反应。结果与T0时相比,两组患者在T1和T2时的BG、E、Cor均增加,特别是两组T1时的E、Cor与T0时比较显著增加(P<0.01);观察组在T1时的E、Cor与对照组比较均明显降低(P<0.05)。对照组T1时的MAP和T1、T2时的HR与T0相比均明显增加(P<0.05或<0.01);观察组T1、T2时的MAP、HR与对照组比较均明显降低(P<0.05或<0.01)。两组患者麻醉效果优良率、丙泊酚用量、术后清醒时间及不良反应发生率组间比较,差异均有统计学意义(P<0.05或<0.01)。结论异丙酚联合酮咯酸氨丁三醇用于老年病人胃镜检查,麻醉效果安全、可靠,能够有效减轻应激反应,检查过程中生命体征平稳、不良反应发生率低。
Objective To investigate the effects of ketorolac tromethamine combined with propofol on hemodynamics and stress response in elderly patients with painless gastroscopy.Methods One hundred and twenty divided into the observation group(ketal acid tromethamine combined with propofol group)and the control group(propofol group),with 60 cases in each group.Finally,58 patients in the observation group and 59 patients in the control group were selected.The pre-anesthesia(T0),gastroscope(T1),and surgery(T2)serum glucose(BG),epinephrine(E),cortisol(Cor)were measured.The changes of MAP,HR and SpO2 in the two groups were recorded.The dose of propofol,postoperative awake time and the anesthetic effect were recorded.The adverse reactions of the patients were observed and recorded.Results Compared with T0,BG,E and Cor of both groups at T1 and T2 increased,especially E and Cor at T1 significantly increased at T0(P<0.01);At T1,E and Cor of the observation group were significantly lower than those of the control group(P<0.05).In the control group,MAP at T1 and HR at T1 and T2 significantly increased,compared with T0(P<0.05 or<0.01);The MAP and HR of the observation group at T1 and T2 significantly reduced,compared with those of the control group(P<0.05 or<0.01).There were significant differences in the rate of excellent anesthesia,propofol dosage,postoperative awake time and adverse reaction rate between the two groups(P<0.05 or<0.01).Conclusion The combination of propofol and ketorolac tromethamine is used in the gastroscopy of elderly patients,with safe and reliable anesthetic effect,which can effectively reduce the stress response,stable vital signs and low incidence of adverse reactions during the examination.
作者
马爱兵
曹新萍
李连涛
MA Aibing;CAO Xinping;LI Liantao(Department of Anesthesia,Hospital of Traditional Chinese Medicine of Boxing,Binzhou 256500,Shandong,P.R.China;Department of Chronic Diseases,Disease Prevention and Control Center of Boxing County)
出处
《滨州医学院学报》
2020年第3期198-201,共4页
Journal of Binzhou Medical University
作者简介
通讯作者:马爱兵,E-mail:sdsbxxmab@163.com。
