咪唑安定联合芬太尼在老年患者胃镜检查的临床观察和护理

目的:探讨咪唑安定联合芬太尼在老年患者胃镜检查中的镇静、镇痛作用及总结护理经验。方法:选60例患者为麻醉组(咪唑安定和芬太尼静脉麻醉),60例为对照组(常规操作),检查前、中、后均给予针对性护理措施。对检查过程中血压、心率、血氧饱和度及检查成功率、检查反应进行观察分析。结果:术中麻醉组MBP、SpO2、HR无明显变化,对照组MBP、HR较术前明显升高(P0.05);麻醉组镇痛评分、镇静分级明显优于对照组(P0.01)。麻醉组、对照组舒适度评分分别为(9.8±0.3)分、(6.1±1.4)分,麻醉组优于对照组(P0.05),麻醉组愿意再次接受胃镜检查56例(93.33%),对照组33例(55.00%),麻醉组明显高于对照组(P0.05)。麻醉组对检查过程完全无记忆47(78.33%)例,记得插入胃镜7例(11.67%),记得拔出胃镜6例(10.00%)。结论:咪唑安定联合芬太尼用于老年患者胃镜检查中具有良好的镇静、镇痛效果,而且安全,护士全面系统施行检查前、中、后的各项护理,是保证老年患者在无痛胃镜检查中安全的重要因素。

Observation and nursing about painless gastroscope examination by Midazolam combination Fentanyl.

Objective：To investigate the sedative and analgesic effect and summary nursing experience of Midazolam combination Fentanyl in painless gastroscope examination. Methods ：120 patients from attending for gas troscopy were randomly chosen and divided into anaesthesia Group （n = 60） and control Group （n = 60）. Anaesthesia group was given Midazolam and Fentanyl, Control group underwent routine operation. Blood pressure, heart rate, pulse oximetry were monitored . The patients＇ reaction and success rate of operation were observed and analyzed. Nursing care was given during the operation. Results： MBP, SpO2, HR did not singnificantly chage during operation in anesthesia group. But MBP and HR was higher in control group （P 〈 0. 05）. Compare to the control greup,analgesie and sedative effect in anesthesia group were more satisfactly （P 〈0.05）. Patients showed more comfortable in anesthesia group （9.8 ±0. 3） score than that of in control group （6. 1 ± 1.4 ） score, （P 〈0.05）. Anaesthesia group showed a significant higher recheck preference percentage （93.33%）, but control group were opposite with the low percentage of 55.00%. 47（78.33% ） patients in anesthesia group had no memory for the course. And only 7 （ 11.67 % ） and 6 （ 10. 00% ） patients had the memory for inserting and pulling out the gastroscope respoctively. Conclusion ： Beside the safty,sedative and analgesic effect of Midazolam combination Fentanyl in gastroscopy is sure and the careful nursing are the guarantees for the successful operation.