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目的探讨一次麻醉行胃肠镜联合检查在老年患者中的可行性。方法 45例麻醉下行联合胃肠镜检查的年龄≥65岁患者作为老年联合组,与92例分次检查的老年患者(老年分次组)和126例联合检查且年龄<65岁的非老年患者(非老年联合组)进行对比。比较3组患者的基础疾病、术后苏醒时间、麻醉药用量、术中生命体征的变化以及不良反应发生率。结果老年联合组患者中高血压病及糖尿病的比例均高于非老年联合组(x~2=10.254、9.164,P=0.001、0.002)。老年联合组的术后苏醒时间长于非老年联合组(t=1.098,P=0.009),但与老年分次组无统计学差异(t=-2.152,P=0.753)。老年联合组舒芬太尼及丙泊酚的用量均低于老年分次组和非老年联合组(t=-1.512、3.176,P=0.012、0.000)。老年联合组的生命体征异常变化发生率高于非老年联合组(x~2=4.250,P=0.039),而与老年分次组之间无统计学差异(x~2=0.572,P=0.449)。老年联合组其它不良反应发生率与老年分次组及非老年联合组比较均无统计学差异(x~2=0.808、2.392,P=0.369、0.122)。结论一次麻醉行胃肠镜联合检查在老年患者中是可行的,但应掌握适应证,宜在麻醉内镜技术成熟以及监护、抢救设施齐全的医院开展。
Objective To investigate the feasibility of an anesthesia combined with gastrointestinal endoscopy in elderly patients. Methods A total of 45 elderly patients aged 65 or older who underwent combined gastrointestinal endoscopy under general anesthesia were enrolled in this study as the elderly combined group with 92 elderly patients (elderly group) and 126 non-elderly patients (age <65) (Non-geriatric joint group) for comparison. Baseline disease, postoperative recovery time, dosage of anesthesia, changes of vital signs during operation and the incidence of adverse reactions were compared between the three groups. Results The proportion of hypertension and diabetes in the elderly combined group was higher than that in the non-elderly combined group (x ~ 2 = 10.254,9.164, P = 0.001,0.002). The recovery time of the elderly combined group was longer than that of the non-elderly combined group (t = 1.098, P = 0.009), but there was no significant difference between the combined group and the elderly group (t = -2.152, P = 0.753). The amount of sufentanil and propofol in the elderly combined group was lower than that in the elderly group and the non-elderly group (t = -1.512, 3.176, P = 0.012,0.000). The incidence of abnormal changes of vital signs in the elderly combined group was higher than that in the non-elderly combined group (x ~ 2 = 4.250, P = 0.039), while there was no significant difference between the elderly combined group and the elderly group (x ~ 2 = 0.572, ). The incidence of other adverse reactions in the elderly combined group was not significantly different from that in the elderly combined group and the non-elderly combined group (x ~ 2 = 0.808,2.392, P = 0.369,0.122). Conclusion An anesthesia combined with gastrointestinal endoscopy is feasible in elderly patients. However, indications should be obtained and it is advisable to carry out the hospital with mature anesthesia endoscopy technology and complete monitoring and rescue facilities.