无痛消化内镜诊疗术的临床应用(附5 200例报告)

目的探讨咪唑安定、异丙酚等药物在消化内镜检查及治疗中应用的安全性和依从性。方法分析5 200例接受消化内镜检查及治疗的患者予咪唑安定 异丙酚 氯胺酮等静脉复合麻醉的临床情况,并以同期5 000例常规操作者为对照组。比较2组患者舒适程度、接受内镜复查及检查成功率。结果(1)无痛组患者感觉舒适率65%,无痛苦率100%,愿意复查率97%。对照组分别为0%、5.5%、14%。(P<0.001)。无痛组肠镜至回盲部率100%,高于对照组的98%。(2)无痛组有8例血氧饱和度下降经处理后顺利完成。本组病例无重大并发症发生。结论咪唑安定、异丙酚、氯胺酮等药物在消化内镜检查及治疗中应用患者感觉舒适、无痛苦,安全性高,增加了患者的依从性。值得临床推广。

Clinical Application on Inspection and Treatment of Painless Gastrointestinal Endoscopy

Objective To research the safety and compliance of joint application of imidazole valiumand propofol during gastrointestinal en-doscopic procedures.Methods 5 200 cases of gastroscopy undertook combined anesthesia of imidazole valium and propofol and ketamine,5 000cases routine procedures.The comfortability and effectivity of two groups were compared.Results(1) In the group treated with painless gastrosco-py,about 65% patients felt comfortable,100% painless and 97% willing to undertake another gastroscopy.The rate in the matched control group is0%,5.5% and 14% respectively(P<0.01).100% enteroscope can reach the ileocecus in painless enteroscopy group.(2)The oxygen satuationdecreased in 8 cases in painless gastroscopy group,but all the patiets completed gastroscopy after correct treatment.There were no serious complica-tions occuring in this group.Conclusion The application of imidazole valium,propofol and ketamine in gastrointestinal endoscopy is comfortable,painless and safe.It has good compliance and desearves to be popularized.