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目的 探讨小剂量依托咪酯复合丙泊酚用于纤维结肠镜检查的临床效果和安全性.方法 选择来本院行无痛纤维结肠镜检查的患者800例,ASA I或Ⅱ级.随机分为小剂量依托咪酯复合丙泊酚组和单纯丙泊酚组.观察并记录麻醉前、麻醉后5 min,两组患者的平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO2)的变化;记录两组患者术中不良反应发生率,包括呼吸抑制、体动、肌颤、恶心呕吐、注射痛等;记录两组患者的麻醉清醒时间.结果 两组患者一般情况差异无统计学意义;而两组患者MAP在麻醉后均有不同程度降低,HR也明显减慢(P<0.05),但SpO2变化不明显;两组间比较,麻醉后依托咪酯复合丙泊酚组MAP明显较高,HR明显较快(P<0.05);术中呼吸抑制(P<0.05)、注射痛(P<0.01)发生率明显降低,但肌肉震颤明显增多(P<0.05);两组患者术中体动、恶心呕吐的发生率和苏醒时间差异无统计学意义.结论 小剂量依托咪酯复合丙泊酚用于纤维结肠镜检查临床效果确切,与单独应用丙泊酚比较,术中能维持相对安全的循环水平,同时也降低了患者不良反应的发生率.“,”Objective To explore the clinical effect and safety of small dose of etomidate composite propofol used in fiber colonoscopy. Methods 800 cases of patients with painless colonoscopy in our hospital were selected,ASA Ⅰ or Ⅱ;randomly divided into two groups:Small dose of etomidate composite propofol group(group A)and the simple application of propofol group(group B). The mean arterial pressure(MAP),heart rate(HR)and SpO2 changes of the two groups before anesthesia and 5 min after anesthesia were observed and recorded. The incidence of adverse reactions in two groups were recorded , including respiratory depression,body movement,muscle fibrillation,nausea,vomiting,injection pain,etc. The anesthesia awake time was recorded in the two groups,too. Results There was no statistically significant difference of the patients′general situation between the two groups.The MAP of patients in both groups decreased in varying degrees after anesthesia and the HR was also slowed down(P<0.05),but he change of SpO2 was not obvious. Compared to group B ,the MAP and HR of patients increased significantly(P<0.05),the intraoperative respiratory depression(P<0.05)and injection pain(P<0.01) was significantly reduced in group A , but the muscle tremor increased significantly (P<0.05). There was no statistically significant difference in the incidence of body movement,nausea,vomiting and the recovery time of patients between the two groups. Conclutions The clinical effect of small dose of etomidate composite propofol used in fiber colonoscopy is definite. Compared with the simple application of propofol ,it can maintain the relatively safe circulation level during operation. And it also reduced the incidence of adverse reactions in patients at the same time.