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[目的]探讨肝硬化患者无痛胃镜检查过程中应用异丙酚作为镇静剂的安全性和可行性。[方法]肝硬化患者(肝硬化组)和非肝硬化患者(对照组)各20例接受异丙酚镇静下的胃镜检查,观察2组患者检查前后及过程中的生命体征,数字连接试验A(NCT-A)及并发症发生情况。[结果]肝硬化组与对照组无痛胃镜检查时间、异丙酚用量相比均差异无统计学意义(P>0.05),2组患者检查过程中血压、心率、呼吸频率均有不同程度下降,至苏醒后均基本恢复,但2组检查后清醒时间比较差异有统计学意义(P<0.05)。肝硬化组与对照组总并发症率以及低血压、低氧血症和心动过缓发生率比较均差异无统计学意义(P>0.05)。肝硬化组操作前后2次NCT-A检查时间均较对照组明显延长(P<0.05),但2组检查前后NCT-A完成时间差异无统计学意义(P>0.05)。[结论]异丙酚用于肝硬化患者无痛胃镜检查安全,未诱发或加重肝性脑病。
[Objective] To investigate the safety and feasibility of using propofol as sedative during painless gastroscopy in cirrhotic patients. [Methods] Twenty patients with cirrhosis (cirrhosis group) and 20 patients without cirrhosis (control group) underwent gastroscopy under the sedation of propofol. The vital signs of the two groups before and during and after the procedure were observed. The digital connection test A (NCT-A) and complications. [Results] There was no significant difference in the time of painless gastroscopy and the dosage of propofol between the cirrhosis patients and the control group (P> 0.05). The blood pressure, heart rate and respiratory rate of the two groups were all decreased to different degrees After recovery, both recovered basically, but there was a significant difference in awake time between the two groups (P <0.05). The total complication rate of cirrhosis and control group and the incidence of hypotension, hypoxemia and bradycardia were not significantly different (P> 0.05). The time of two NCT-A examinations before and after cirrhosis was significantly longer than that of the control group (P <0.05), but there was no significant difference between the two groups in NCT-A completion time (P> 0.05). [Conclusion] Propofol is safe for painless gastroscopy in patients with liver cirrhosis and does not induce or aggravate hepatic encephalopathy.