一氧化二氮联合咪达唑仑镇静在老年结肠镜检查中的效用分析

目的与普通结肠镜检查相比,研究老年患者中一氧化二氮联合咪达唑仑镇痛镇静方法的可行性。方法将2014年1月~2014年12月在笔者医院自愿行一氧化二氮联合咪达唑仑镇静镇痛结肠镜检查的388例60岁及以上的老年患者作为无痛肠镜组,同期行普通肠镜检查的174例老年患者作为普通肠镜组,对其镇静程度、检查时间、术后恢复时间、心率、平均动脉压、血氧饱和度、不良反应、医患满意度等进行比较分析。结果无痛肠镜组患者以轻中度镇静为主,肠镜进镜检查时间为6.6±2.7min,明显短于普通肠镜组(7.6±3.9min,P<0.05),恢复时间为50.0±14.5s,术中心率和平均动脉压较术前降低,但在安全范围内,血氧饱和度无明显改变。无痛肠镜组医患满意度及不适反应均显著优于普通肠镜组(P<0.05)。结论一氧化二氮联合咪达唑仑镇痛镇静在老年患者结肠镜检查操作中具有可行性。

Safety and Efficacy of Nitrous Oxide Combined with Midazolam in Elderly Colonoscopy

Objective To evaluate the availability of nitrous oxide (N₂O)combined with midazolam in elderly colonoscopy. Methods A total of 562 elderly patients who underwent colonoscopies from January to December 2014 were divided into analgesia group (N₂O with midazolam colonoscopy, n=388) and conventional group(conventional colonoscopy, n=174). Sedative effects, adverse reactions of all patients were observed.Heart rate, mean blood pressure and oxygen saturation were monitored before, during and after colonoscopies. Operating time and recovery time were recorded. Patients'' and doctors'' self-feelings were recorded by questionnaire survey after colonoscopies. Results N₂O with midazolam colonoscopy group were in status of mild-to-moderate sedation, and operating time was 6.6±2.7 min which was decreased (P<0.05) compared with conventional group, and the recovery time was 50.0±14.5s.The heart rate and mean blood pressure during operating were decreased slightly but in safe intervals compared with that of before operating in analgesia group, and no statistical significance was detected in oxygen saturation.The adverse reaction incidence, satisfaction were better in analgesia group (P<0.05). Conclusion N₂O combined with midazolam in elderly colonoscopy is feasible.