标题：不同比例依托咪酯与丙泊酚混合用于无痛胃肠镜检查的麻醉效果

      作者：和优娟，喻倩    空军军医大学第二附属医院麻醉科，陕西 西安 710038

      卷次： 2019年30卷22期

      【摘要】 目的 研究不同比例依托咪酯与丙泊酚混合用于无痛胃肠镜检查中的麻醉效果。方法 选取2016年3月至2018年8月空军军医大学第二附属医院行胃肠镜检查的122例患者作为研究对象，根据检查时麻醉药物用量的不同将其分为A组62例和B组60例，A组采用依托咪酯/丙泊酚混合液进行麻醉，用量比为20 mg：100 mg，B组患者采用依托咪酯/丙泊酚混合液进行麻醉，用量比为20 mg：200 mg。比较两组患者麻醉前、麻醉后1 min，麻醉后5 min、麻醉苏醒时的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO2)水平，同时比较两组患者的检查时间、清醒时间和检查后的不良反应发生情况。结果 A组患者麻醉前、麻醉后1 min、麻醉后5 min、检查结束时的MAP分别为 (101.43 ± 12.75) mmHg、(98.65 ± 11.51) mmHg、(97.94 ± 10.46) mmHg、(99.26 ± 12.67) mmHg，对照组分别为(101.67±12.57) mmHg、(104.66±11.38) mmHg、(84.74±10.3) mmHg、(90.15±12.52) mmHg。经重复测量方差分析结果显示，在时间因素、时间交互因素和组间因素方面比较，差异均有统计学意义(P<0.05)。A组患者麻醉前、麻醉后1 min、麻醉后 5 min、检查结束时的HR分别为(77.98±6.82)次/min、(77.21±6.41)次/min、(76.16±6.8)次/min、(76.49±4.83)次/min；B组分别为(78.48±5.62)次/min、(76.99±6.34)次/min、(75.83±6.56)次/min、(76.24±5.07)次/min。经重复测量方差分析结果显示，仅在时间因素方面比较差异有统计学意义(P<0.05)。A组患者麻醉前、麻醉后1 min、麻醉后 5 min、检查结束时的 SpO2分别为(98.36±1.78)%、(98.24±1.33)%、(97.97±1.59)%、(98.17±0.68)%，B组分别为(98.59±1.47)%、(98.08±1.17)%、(97.53±1.37)%、(98.05±0.78)%。经重复测量方差分析结果显示，仅在时间因素方面比较差异有统计学意义(P<0.05)；两组患者的检查时间、清醒时间以及检查后发生的不良反应比较，差异均无统计学意义(P>0.05)。结论 依托咪酯/丙泊酚(20 mg/100 mg)混合液对患者MAP、HR、SpO2影响较小，更适合胃肠镜检查中应用。
      【关键词】 依托咪酯；丙泊酚；无痛胃肠镜；麻醉；效果
      【中图分类号】 R57 【文献标识码】 A 【文章编号】 1003—6350（2019）22—2954—03

Anesthetic effect of different proportion of etomidate and propofol in painless gastroenteroscopy.
HE You-juan,YU Qian. Department of Anesthesiology, the Second Affiliated Hospital of Air Force Military Medical University, Xi'an710038, Shaanxi, CHINA
【Abstract】 Objective To study the anesthetic effect of different proportions of etomidate and propofol in pain-less gastroscopy. Methods From March 2016 to August 2018, 122 patients undergoing gastroenteroscopy in the SecondAffiliated Hospital of Air Force Military Medical University were selected as the subjects of study. According to the differ-ent amount of narcotic drugs used in the examination, they were divided into group A (62 cases) and group B (60 cases).Group A was anesthetized with etomidate/propofol mixture (20 mg: 100 mg), and group B was anesthetized with etomi-date/propofol mixture (20 mg: 200 mg). The heart rate (HR), mean arterial pressure (MAP) and blood oxygen satura-tion (SpO2) of the patients in the two groups were compared before anesthesia, 1 min after anesthesia, 5 min after anes-thesia, and at anesthesia recovery. The examination time, awake time, and adverse reactions of the two groups werecompared. Results In group A, MAP before anesthesia, 1 min after anesthesia, 5 min after anesthesia, at the end ofexamination was (101.43±12.75) mmHg, (98.65±11.51) mmHg, (97.94±10.46) mmHg, (99.26±12.67) mmHg, versus(101.67±12.57) mmHg, (104.66±11.38) mmHg, (84.74±10.3) mmHg, (90.15±12.52) mmHg in group B. The varianceanalysis of variance showed that the difference in time factor, time interaction factor, inter-group factors was statisti-cally significant (P<0.05). In group A, the HR was (77.98±6.82) beats/min, (77.21±6.41) beats/min, (76.16±6.8) beats/min,(76.49 ± 4.83) beats/min, versus (78.48 ± 5.62) beats/min, (76.99 ± 6.34) beats/min, (75.83 ± 6.56) beats/min, (76.24 ±5.07) beats/min in group B (P<0.05). In group A, the SpO2 was (98.36±1.78)%, (98.24±1.33)%, (97.97±1.59)%, (98.17±0.68)%, versus (98.59±1.47)%, (98.08±1.17)%, (97.53±1.37)%, (98.05±0.78)% in group B. The analysis of varianceshowed that there was significant difference only in time factor (P<0.05). There was no significant difference in the ex-amination time, the awake time, and adverse reactions between the two groups (P>0.05). Conclusion Etomidate/propo-fol (20 mg/100 mg) mixture has little effect on MAP, HR, SpO2, which is more suitable for gastroenteroscopy.
      【Key words】 Etomidate; Propofol; Painless gastroenteroscopy; Anesthesia; Effect