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                      学术堂专业论文学习平台您当前的位置:学术堂 > 医学论文 > 临床医学论文 > 麻醉学论文

                      无痛胃镜诊断患者采用右美托咪定的麻醉效果

                      时间:2019-03-20 来源:当代医学 作者:刘文彬,吴福波,朱超 本文字数:4398字

                        摘    要: 目的 研究右美托咪定在无痛胃镜中的麻醉疗效。方法 选取2017年3月至2019年7月在本院接受无痛胃镜诊断的患者78例为研究对象,按照随机方式分为观察组和参照组,各39例;观察组在采取右美托咪定麻醉,参照组采取丙泊酚麻醉,对比两组患者的麻醉效果、不良反应发生率以及诊断满意率。结果 两组患者的麻醉效果进行对比,观察组患者的疼痛度、诊断时间、苏醒时间低于参照组,差异有统计学意义(P<0.05);两组患者的不良反应发生率对比,观察组低于参照组(P<0.05);两组患者的诊断满意率对比,观察组明显高于参照组,差异有统计学意义(P<0.05)。结论 右美托咪定在无痛胃镜诊断中的麻醉应用效果良好,可以有效降低期间患者的疼痛度、诊断时间、苏醒时间、不良反应,且能提高诊断满意度。

                        关键词: 右美托咪定; 无痛胃镜; 麻醉; 疗效;

                        Abstract: Objective To study the anesthesia efficacy of dexmedetomidine in painless gastroscopy. Methods A total of 78 patients with painless gastroscopy diagnosed in our hospital from March 2017 to July 2019 were selected as study subjects. They were randomly divided into observation group and reference group, with 39 cases in each group. For anesthesia, propofol anesthesia was used in the reference group, and the anesthesia effect, adverse reaction rate, and diagnosis satisfaction rate were compared between the two groups. Results The anesthesia effects of the two groups of patients were compared. The pain, diagnosis time, and wake-up time of the observation group were lower than those of the reference group,and the differences was statistically significant(P<0.05). The incidence of adverse reactions was compared between the two groups of patients. The group was lower than the reference group(P<0.05). The satisfaction rate of the patients in the two groups was significantly higher than that in the reference group, and the difference was statistically significant(P<0.05). Conclusion Dexmedetomidine has a good anesthesia application in painless gastroscopy diagnosis. It can effectively reduce the patient's pain, diagnosis time, wake-up time, and adverse reactions, and it can also improve the diagnosis satisfaction.

                        Keyword: Dexmedetomidine; Painless gastroscopy; Anesthesia; Efficacy;

                      星云棋牌官网下载   WEIJINGZHENDUANSHILINCHUANGZHONGZHENDUANWEIBINGJIWEIPUBIANDEYIZHONGDEZHENDUANFANGFA,ZAIYINGYONGGUOCHENGZHONGCAOZUOJIAOWEIFANGBIAN,ZHENDUANSHISHIYEQINGXI,JUYOUSHIFENMINGXIANDEYOUSHI[1]。ERCHUANTONGWEIJINGSHIJIANGWEIJINGZHIJIECONGHUANZHEDESHIGUANCHARUWEIBU,ZAICHARUGUOCHENGZHONG,HUICHUXIANYIXILIEBULIANGFANYING,LIRUEXIN、OUTUDENGXIANXIANG,ZAIYINGYONGGUOCHENGZHONG,YICUNXINGBUJIA,HUIJIANJIEDIDUIZHENDUANJIEGUOZAOCHENGYIDINGYINGXIANG。SUIZHEYIXUESHUIPINGBUDUANFAZHAN,JINNIANLAIWUTONGWEIJINGDEDANSHENGWEIWEIBINGZHENDUANTIGONGJIJIADEQIJI,GAISHOUDUANZAILINCHUANGZHONGDEGUANGFANYINGYONG,JINYIBUTISHENGLEZHENDUANDEZHUNQUEXING,TONGSHIJIANGDIZHENDUANGUOCHENGDEBUSHIDU[2]。BENYANJIUXUANQUBENYUANSHOUZHIDEJIESHOUWUTONGWEIJINGZHENDUANDEHUANZHE78LIZUOWEIYANJIUDUIXIANG,TANSUOYOUMEITUOMIDINGZAIWUTONGWEIJINGZHONGDEMAZUIYINGYONGXIAOGUO,XIANBAODAORUXIA。

                        1 、资料与方法

                        1.1 、临床资料

                        选取2017年3月至2019年7月在本院接受无痛胃镜诊断的患者78例,随机分为观察组和参照组,各39例。观察组男20例,女19例;年龄22~65岁,平均年龄(41.14±3.78)岁。参照组男18例,女21例;年龄21~64岁,平均年龄(39.08±3.97)岁。两组患者临床资料比较差异无统计学意义,具有可比性。纳入标准:无精神类疾病,同时无其他严重器官类疾病,交流无障碍;对本研究内容知情且同意;得到本院医学伦理会批准。排除标准:对本研究所用药物有过敏史;患有严重的传染类疾病;拟纳入或已纳入其他研究项目。
                       

                      无痛胃镜诊断患者采用右美托咪定的麻醉效果
                       

                        1.2 、方法

                      星云棋牌官网下载   LIANGZUHUANZHEDESHOUSHUQIANBUCAIQURENHEYAOWUFUZHU,DAIJINRUSHOUSHUSHI,SHOUXIANWEIHUANZHETIGONGXIANGTONGDEXINLIJIANHU,JISHIJIANLIJINGMAITONGDAO,ZHUNBEIGONGZUOWANBIHOU,CANZHAOZUCAIQUBINGBOFENZHILIAO,YIJINGMAIZHUSHEFANGSHIMAZUI,BINGBOFEN[Fresenius Kabi AB(GUOCHAN),GUOYAOZHUNZIJ20080023],YINGYONGLIANGWEI2.5 mg/kg。GUANCHAZUCAIQUYOUMEITUOMIDINGMAZUI,YOUMEITUOMIDING(JIANGSUHENGRUIYIYAOGUFENYOUXIANGONGSI,GUOYAOZHUNZIH20090248)YINGYONGLIANGWEI0.8μg/kg。MAZUIHOUDAIHUANZHERUSHUI,LIJISHISHIWEIJINGZHENDUAN,ZAIZHENDUANGUOCHENGZHONG,YAOQIUHULIRENYUANSUISHIGUANCHAHUANZHEDEGEXIANGSHENGMINGTIZHENG,RUFASHENGYICHANG,XUYAOJISHIBAOBEIYISHI,CAIQUXIANGDUIJIJIUSHOUDUAN。RUOHUANZHECHUXIANSUXINGZHUANGKUANG,ZEKEJIXUJIAYONGBINGBOFEN1 mg/kg,JIYUYIDINGDEXIYANGZHICHI。RUGUOHUANZHEMIANSEYIYANG,CHENGXIANFAZI、FAHEIXIANXIANG,XULIJITINGZHIZHENDUAN,ZHUNBEIJIJIU。

                        1.3、 观察指标

                        DUIBILIANGZUHUANZHEDEMAZUIXIAOGUO,DUIBITENGTONGDU、ZHENDUANSHIJIAN、SUXINGSHIJIAN;DUITENGTONGDUCAIQUBENYUANZIZHIDETENGTONGDUCEPINGBIAOJINXINGPINGFEN,MANFEN10FEN,DEFENYUEGAOSHUOMINGTENGTONGDUYUEQIANGLIE。

                      星云棋牌官网下载   ZHENDUANJIESHUHOU,TONGJILIANGZUHUANZHEDEBULIANGFANYINGQINGKUANG,BAOKUO:EXIN、OUTU、TOUYUN、JINGSHENBUZHEN。

                        DUILIANGZUHUANZHEZAIZHENDUANQIJIANDEMANYIDUJINXINGDUIBI,MANYICHENGDUFENWEIJIWEIMANYI、JIAOWEIMANYI、YIBANMANYI、BUMANYI。JIWEIMANYI:ZAICICIZHENDUANZHONG,MAZUIJIESHUHOU1ZHOUNEIWEICHUXIANRENHEYICHANGFANYING,TONGSHIMAZUISUXINGSHIWUBUSHIGAN;JIAOWEIMANYI:MAZUIJIESHUSUXINGSHI,YOUQINGWEIDEBUSHIGAN,DANBUSHIGANBINGBUQIANGLIE,ZHENGTIWUYINGXIANG;YIBANMANYI:MAZUIJIESHUHOUCHUXIANQINGWEITOUYUNDENGBUSHIZHENG,BUSHIZHENGZAIZHENDUANJIESHUHOU1ZHOUNEICHUXIANCISHU≤2CI;BUMANYI:MAZUIJIESHUHOUDE1ZHOUNEI,CHUXIANDEBULIANGFANYING>2CI,YINGXIANGHUANZHEZHENGCHANGSHENGHUOZHILIANG。ZONGMANYILV=(JIWEIMANYI+JIAOWEIMANYI+YIBANMANYI)/ZONGLISHU×100%。

                        1.4 、统计学方法

                        BENYANJIUSHUJUJUNYONGSPSS 20.0TONGJIRUANJIANCHULI,JILIANGZILIAOCAIYONG“±s”BIAOSHI,ZUJIANBIJIAOCAIYONGtJIANYAN,JISHUZILIAOYONGLISHU(n)BIAOSHI,JISHUZILIAOZUJIANLV(%)DEBIJIAOCAIYONGX2JIANYAN,P<0.05WEICHAYIYOUTONGJIXUEYIYI。

                        2 、结果

                        2.1 、两组患者疼痛度、诊断时间、苏醒时间对比

                        MAZUIHOU,LIANGZUHUANZHEDETENGTONGDU、ZHENDUANSHIJIAN、SUXINGSHIJIANBIJIAOCHAYIJUYOUTONGJIXUEYIYI(P<0.05),JIANBIAO1。

                        表1 两组患者疼痛度、诊断时间、苏醒时间对比(±s)
                      表1 两组患者疼痛度、诊断时间、苏醒时间对比(±s)

                        2.2、 两组患者不良反应发生率对比

                      星云棋牌官网下载   LIANGZUHUANZHEBULIANGFANYINGFASHENGLVBIJIAOCHAYIJUYOUTONGJIXUEYIYI(P<0.05),JIANBIAO2。

                        2.3 、两组患者诊断满意率对比

                        GUANCHAZUJIWEIMANYI18LI(46.15%),JIAOWEIMANYI12LI(30.76%),YIBANMANYI7LI(17.94%),BUMANYI2LI(5.12%),MANYILVWEI94.87%;CANZHAOZUJIWEIMANYI17LI(43.58%),JIAOWEIMANYI8LI(20.51%),YIBANMANYI4LI(10.25%),BUMANYI10LI(25.64%),MANYILVWEI74.35%,LIANGZUBIJIAOCHAYIJUYOUTONGJIXUEYIYI(P<0.05),JIANBIAO3。

                        3 、讨论

                        WEIJINGZHENDUANZAIXIAOHUANEIKEZHONGDEYINGYONGSHIFENGUANGFAN,YINWEIZHEIZHONGSHOUDUANHUILINGHUANZHEBUSHIGANDADAJIANGDI,QIJIANGENGWEISHUSHI,BUYIYINFABULIANGFANYING[3]。XIANGBIYUCHUANTONGDEWEIJINGZHENDUAN,YOUYUZHENDUANFANGSHIDEXIANZHI,HUILINGHUANZHECHUXIANBUTONGCHENGDUDEBUSHIGAN,YINGXIANGHUANZHEDUIJIANCHADEYICUNXING。CONGMUQIANDEXINGSHIFENXI,CHUANTONGDEWEIJINGZHENDUANYIJUWUFAMANZULINCHUANGYAOQIU,ZAIJIASHANGWUTONGWEIJINGDEGUANGFANYINGYONG,JIAJULECHUANTONGWEIJINGZHENDUANXIAOSHI。ERYINGYONGWUTONGWEIJINGDEYOUSHIZAIYUMIBULEYIWANGZHONGCHUXIANDEBUZU,LIRUXIANGBIYUCHUANTONGWEIJING,GAIFANGSHIKEZAIANQUANXING、BIANLIXINGYIJIKECAOZUOXINGSHANGJIEZHANJUYOUSHI,TONGSHIZHENDUANDEZHUNQUELVYEGENGGAO[4]。DANGHUANZHECAIQUWUTONGWEIJINGDEZHENDUANFANGSHIJINXINGMAZUI,ERCHANGJIANDEMAZUIYAOWUWEIBINGBOFEN,GAIYAOWUZAILINCHUANGZHONGDEYINGYONGSHIFENPUBIAN,YINGYONGMIANJIYEXIANGDANGGUANGFAN[5];CONGYIWANGDEYINGYONGHELINCHUANGANLIZHONGKEYIFENXIDECHU,BINGBOFENZAIDUANXIAOSHOUSHUZHONGSHIDANCHUNJINGMAIQUANMADELIXIANGYONGYAO,YINWEIGAIYAODETEDIANWEIQIXIAOKUAI,SUXINGYEKUAI,DUIHUANZHEDEXUEGUANYIJIHUXIYOUYIDINGDEYIZHIZUOYONG[6]。DANSHIZAISHIYONGBINGBOFENMAZUISHI,XUYAOJINXINGMAZUIYOUDAO,YOUDAOQIJIANKENENGHUISHIHUANZHECHUXIANJUBUXINGTENGTONG,DUIHUANZHESHENJINGYIHUIZAOCHENGYIDINGYINGXIANG,DAIMAZUIWANBISUXINGHOU,HUANZHEHUICHUXIANZANSHIXINGDEEXIN、OUTUDENGBULIANGFANYING,CIWAIYEHUIDUISHIYONGJILIANGCHANSHENGYIDINGDEYILAIXING,MAZUIQIJIANHUIDUIHUANZHEHUXIXUNHUANXITONGZAOCHENGYIDINGYINGXIANG,ZAILINCHUANGZHONGBUSHIYINGTUIGUANG[7]。GUBENYANJIUYOUMEITUOMIDINGDEMUDEZAIYUTANSUOWUTONGWEIJINGZHONGGENGWEIYOUXIAODEMAZUIFANGSHI,YIGONGHOUXULINCHUANGCANKAOHEBANGZHU。

                          表2 两组患者不良反应发生率对比[n(%)]
                      表2 两组患者不良反应发生率对比[n(%)]

                        表3 两组患者诊断满意率对比[n(%)]
                      表3 两组患者诊断满意率对比[n(%)]

                      星云棋牌官网下载   BENYANJIUZHONGLIANGZUHUANZHEDETENGTONGDU、ZHENDUANSHIJIAN、SUXINGSHIJIANDUIBICHAYIJUYOUTONGJIXUEYIYI(P<0.05);LIANGZUHUANZHEEXIN、OUTU、TOUHUN、JINGSHENBUZHENDENGFASHENGLVBIJIAOCHAYIWUTONGJIXUEYIYI,DANZONGTIDEBULIANGFANYINGFASHENGLVGUANCHAZUDIYUCANZHAOZU,BIJIAOCHAYIJUYOUTONGJIXUEYIYI(P<0.05);LIANGZUHUANZHEZAIZHENDUANQIJIANDEMANYICHENGDU,GUANCHAZUGAOYUCANZHAOZU,BIJIAOCHAYIJUYOUTONGJIXUEYIYI(P<0.05)。YOUMEITUOMIDINGSHUYUXINXINGDEαSHENSHANGXIANSHOUTIJIDONGJI,KEYIZHIJIEZUOYONGYUHUANZHENAOBUYIJIJISUIαSHOUTI,CONGERDADAOMAZUIMUDE,JINYIBUJIANGDIHUANZHEZAIZHENDUANGUOCHENGZHONGDEBUSHIGAN;BINGQIEGENJUDALIANGDELINCHUANGYANJIUZHENGMING,GAIYAOWUDUISHOUZHEDEJITIDEYINGXIANGJIAOSHAO,TONGSHIDUIXUEYAYIJIHUXIXUNHUANXITONGDEYINGXIANGYEXIANGDUIJIAOSHAO[8]。CHUCIZHIWAI,YOUMEITUOMIDINGHAIJUYOUYIDINGDEZHENTONGYUZHENJINGXIAOGUO,ZHUYAOZUOYONGYULANBANHEGUSUIDEWEIZHI,DUIHUANZHEDEJIAOGANSHENJINGYOUYIDINGDEYIZHIZUOYONG,SHIYONGHOUZAIJIFASHENJINGZHONGSHUTUCHUQIANDEαSHOUTISHI,TONGSHIKEYIYIZHIQUJIASHENSHANGXIANFENMI,CONGERQIDAOZHENJINGHEZHENTONGDEZUOYONG[9]。RUOJIANGYOUMEITUOMIDINGYUBINGBOFENDUIBI,YOUMEITUOMIDINGYONGYUWUTONGWEIJINGZHENDUANZHONGSHI,KEYIGENGWEIYOUXIAODEHUANJIEHUANZHECHUXIANBULIANGFANYINGDECISHU,YENENGQIDAOYIDINGDEJIANGDIHUXIYIZHIZUOYONG,TONGGUODUIXINXUEGUANZHONGSHUXITONGJINXINGDIAOJIE,KEYIYOUXIAOJIANGDIHUANZHEJIAOGANSHENJINGJINZHANGDU,LINGWAIYENENGJIANGDIHUANZHEDEXUEYAHEXINLVBIANHUASHUIPING,FANGZHICHUXIANQITAYANZHONGBINGFAZHENGYIJIBULIANGFANYING[10]。TONGGUOBENYANJIUKEYIKANCHUYOUMEITUOMIDINGZAIYINGYONGZHONGQUESHIQIDAOLIANGHAODEMAZUIZUOYONG,ERQIEDUIHUANZHEYINGXIANGBULIANGJIAOXIAO。

                        ZONGSHANGSUOSHU,CAIQUYOUMEITUOMIDINGZAIWUTONGWEIJINGZHENDUANMAZUIZHONGDEYINGYONGXIAOGUOLIANGHAO,KEYIYOUXIAOJIANGDIQIJIANHUANZHEDETENGTONGDU、ZHENDUANSHIJIAN、SUXINGSHIJIAN、BULIANGFANYINGFASHENG,QIENENGTIGAOZHENDUANMANYIDU,LINCHUANGYINGYONGXIAOGUOXIANZHE,ZHIDETUIGUANG。

                        参考文献

                        [1]肖金辉,王敏华,艾金莲,等.右美托咪定复合小剂量瑞芬太尼在局麻经皮椎体后凸成形术患者中的应用[J].中国实验诊断学,2018,22(2):286-288.
                        [2] 于璇,贺亮,李爱国.小剂量右美托咪定复合靶控输注异丙酚在肥胖患者无痛肠镜诊断中的应用[J].河北医药,2018,40(2):188-191.
                        [3]杨晓春,谢咏秋,赵婉莹,等.不同配比依托咪酯-丙泊酚混合液在无痛胃镜中的应用比较[J].临床麻醉学杂志,2018,34(3):246-249.
                        [4] 吴莉,郭春燕,解雅英,等.不同剂量瑞芬太尼并丙泊酚靶控输注行无痛胃镜诊断对冠心病患者循环稳定及心肌的影响[J].临床误诊误治,2018,31(3):69-72.
                        [5] 李欢,荣加.右美托咪定与丙泊酚在胃镜诊断中的应用效果及危险因素分析[J].解放军医药杂志,2017,29(5):103-106,115.
                        [6] 王建平,孟凡民.右美托咪定喷鼻在小儿无痛电子结肠镜诊断术中的应用效果[J].中华消化内镜杂志,2017,34(2):112-117.
                        [7] 庄延,昝京伟,刘国凯.术前耳穴贴压治疗对无痛胃镜诊断中呼吸循环抑制的影响[J].北京医学,2017,39(3):276-278.
                        [8]郭波,汤伟.异丙酚和依托咪酯复合瑞芬太尼对老年无痛胃镜患者的呼吸循环系统影响的比较[J].重庆医学,2017,46(5):628-631.
                        [9]敖程斌,黄月红,胡战兵.右美托咪定与丙泊酚联用于老年患者无痛胃镜麻醉的临床观察[J].中国药师,2016,19(2):306-307.
                        [10]王浩,韩利锋,杨小波,等.瑞芬太尼与右美托咪定在老年患者椎体成形术及椎体后凸成形术监护性麻醉中的临床效果比较[J].中国实验诊断学,2018,22(3):412-415.

                        论文来源参考:刘文彬,吴福波,朱超.右美托咪定应用于无痛胃镜中的麻醉临床疗效分析[J].当代医学,2020,26(08):64-66.
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