酮咯酸氨丁三醇联合丙泊酚对老年患者无痛胃镜检查血流动力学及应激反应的影响

目的 探讨酮咯酸氨丁三醇联合丙泊酚对老年患者无痛胃镜检查术血流动力学及应激反应的影响。方法 按照随机数字表法将120例需进行无痛胃镜检查的患者分为观察组(酮咯酸氨丁三醇联合丙泊酚组)和对照组(单纯丙泊酚组),每组各60例。最终入选观察组58例、对照组59例。检测两组患者麻醉前(T₀)、置入胃镜时(T₁)、术毕(T₂)血清中血糖(BG)、肾上腺素(E)、皮质醇(Cor)的含量并记录两组患者各时间点MAP、HR、S_PO₂的变化;记录两组患者丙泊酚用量、术后清醒时间并对麻醉效果进行评价;观察并记录术中病人出现的不良反应。结果 与T₀时相比,两组患者在T₁和T₂时的BG、E、Cor均增加,特别是两组T₁时的E、Cor与T₀时比较显著增加(P<0.01);观察组在T₁时的 E、Cor与对照组比较均明显降低(P<0.05)。对照组T₁时的MAP和T₁、T₂时的HR与T₀相比均明显增加(P<0.05或<0.01);观察组T₁、T₂时的MAP、HR与对照组比较均明显降低(P<0.05或<0.01)。两组患者麻醉效果优良率、丙泊酚用量、术后清醒时间及不良反应发生率组间比较,差异均有统计学意义(P＜0.05或＜0.01)。结论 异丙酚联合酮咯酸氨丁三醇用于老年病人胃镜检查,麻醉效果安全、可靠,能够有效减轻应激反应,检查过程中生命体征平稳、不良反应发生率低。

Effects of ketorolac tromethamine combined with propofol anesthesia on hemodynamics and stress response in elderly patients undergoing painless gastroscopy

Objective To investigate the effects of ketorolac tromethamine combined with propofol on hemodynamics and stress response in elderly patients with painless gastroscopy.Methods One hundred and twenty divided into the observation group (ketal acid tromethamine combined with propofol group) and the control group (propofol group), with 60 cases in each group. Finally, 58 patients in the observation group and 59 patients in the control group were selected. The pre-anesthesia (T₀), gastroscope (T₁), and surgery (T₂) serum glucose (BG), epinephrine (E), cortisol (Cor) were measured. The changes of MAP, HR and SpO₂ in the two groups were recorded. The dose of propofol, postoperative awake time and the anesthetic effect were recorded. The adverse reactions of the patients were observed and recorded.Results Compared with T₀, BG, E and Cor of both groups at T₁ and T₂ increased, especially E and Cor at T₁ significantly increased at T₀ (P＜0.01); At T₁, E and Cor of the observation group were significantly lower than those of the control group (P＜0.05). In the control group, MAP at T₁ and HR at T₁ and T₂ significantly increased, compared with T₀ (P＜0.05 or ＜0.01); The MAP and HR of the observation group at T₁ and T₂ significantly reduced, compared with those of the control group (P＜0.05 or ＜0.01). There were significant differences in the rate of excellent anesthesia, propofol dosage, postoperative awake time and adverse reaction rate between the two groups (P＜0.05 or ＜0.01).Conclusion The combination of propofol and ketorolac tromethamine is used in the gastroscopy of elderly patients, with safe and reliable anesthetic effect, which can effectively reduce the stress response, stable vital signs and low incidence of adverse reactions during the examination.