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目的探讨胃癌切除患者丙泊酚全身静脉麻醉下进行胃肠镜联合检查的效果。方法进行胃肠镜联合检查的胃癌切除患者120例根据随机抽签原则分为治疗组60例与对照组60例,治疗组静注布托啡诺针,对照组注芬太尼针,两组同时均静注丙泊酚针,直至患者睫毛反射消失即可置入胃肠镜检查。结果所有患者都完成胃肠镜检查,注药后2min与注药前比较,患者的MAP与HR均明显下降(P<0.05),同时MAP和HR在组间相比较无显著性差异(P>0.05),其余时间点的上述值在组内与组间比较均无显著性差异(P>0.05)。治疗组的睫毛反射消失时间和指令睁眼时间都明显少于对照组,治疗组停药后10min与20min的Ramesay评分明显高于对照组,对比差异有统计学意义(P<0.05)。检查后两组的头晕、恶心呕吐、皮肤瘙痒等不良反应发生率对比差异无统计学意义(P>0.05),经过对症处理后都明显好转。结论相对于芬太尼,胃癌切除患者采用布托啡诺复合丙泊酚全身静脉麻醉下进行胃肠镜联合检查对于患者的心率与血压影响小,具有更好的麻醉镇静效果,安全性好,值得推广应用。
Objective To investigate the effect of gastrointestinal endoscopy combined with propofol general anesthesia in patients with gastric cancer. Methods According to the principle of random lottery, 120 patients with gastric cancer underwent gastrointestinal endoscopy were divided into treatment group (60 cases) and control group (60 cases). The treatment group was given intravenous injection of butorphanol and the control group was given fentanyl. At the same time, Intravenous injection of propofol needle until the patient disappeared eyelashes can be placed in gastrointestinal endoscopy. Results All patients completed the gastrointestinal endoscopy. MAP and HR decreased significantly (P <0.05) at 2 min after injection compared with those before injection. There was no significant difference in MAP and HR between the two groups (P> 0.05). There was no significant difference between the above groups in other groups (P> 0.05). The eyelash reflex disappear time and eye opening time in the treatment group were significantly less than those in the control group. The Ramesay scores of the 10 min and 20 min after treatment in the treatment group were significantly higher than those in the control group, with significant difference (P <0.05). There was no significant difference in the incidence of dizziness, nausea, vomiting and skin pruritus between the two groups after the examination (P> 0.05). After symptomatic treatment, the incidence of adverse reactions was significantly improved. Conclusions Compared with fentanyl, gastrointestinal endoscopy combined with butorphanol in combination with propofol for systemic gastric resection has little effect on heart rate and blood pressure in patients with gastric cancer resection, which has better anesthetic sedation, better safety, Worth promoting application.