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目的了解静脉麻醉下胃镜、结肠镜不同时间顺序检查麻醉药物平均用量、麻醉时间及不良反应。方法将住院或门诊同时需要进行胃镜和结肠镜检查且自愿选择在静脉麻醉下进行检查的患者165例随机分为2组:A组82例(早晨作胃镜,下午作结肠镜),B组83例(下午先作胃镜,随后作结肠镜),记录麻醉时间、用药平均量和不良反应发生情况。结果在检查的165例患者中,都能达到胃肠镜检查的满意麻醉、镇静效果,均顺利成功完成了检查。A组有4例在进行结肠镜操作过程中出现呕吐胃内容物,经及时积极处理后完成检查。部分患者在用麻药后出现不自主手足活动或躯体扭动,在小剂量增加丙泊酚后逐渐安静。检查结束后A组5例,B组6例出现精神兴奋,未发生内镜检查穿孔及死亡等严重并发症,未出现因麻醉并发症而终止胃肠镜检查者。A组所用丙泊酚平均量和所用麻醉时间与B组相比较差异有显著统计学意义(P<0.0005)。结论临床上对于要进行静脉麻醉下胃镜、结肠镜检查的患者,最好先进行胃镜检查,随后立即进行结肠镜联合检查,这是较为科学合理的选择方案。
Objective To understand the endoscopic venous anesthesia, colonoscopy at different times to check the average amount of narcotic drugs, anesthesia time and adverse reactions. Methods One hundred and sixty-five patients who underwent gastroscopy and colonoscopy at the same time in hospital or outpatient department and who voluntarily chose to undergo venous anesthesia were randomly divided into two groups: group A (n = 82), gastroscopy (morning) and colonoscopy Example (afternoon gastroscopy, followed by colonoscopy), record the anesthesia time, the average amount of medication and adverse reactions. Results In the examination of 165 patients, satisfactory gastrointestinal endoscopic anesthesia and sedation results were successfully completed the examination. A group of 4 patients in the process of colonoscopy during vomiting stomach contents, after timely and positive treatment to complete the inspection. Some patients after anesthesia with involuntary hand-foot activities or body writhing, after a small dose of propofol increased gradually quiet. After the examination, 5 patients in group A and 6 patients in group B appeared mental excitement. There were no serious complications such as perforation and death of endoscopy. There was no termination of gastrointestinal endoscopy because of complications of anesthesia. The average amount of propofol used in group A and the duration of anesthesia used were significantly different from those in group B (P <0.0005). Conclusions For patients undergoing endoscopy and colonoscopy under intravenous anesthesia, it is best to carry out gastroscopy first and then colonoscopy combined immediately. This is a more scientific and reasonable choice.