镇静等级对胃镜下止血治疗的影响

目的研究不同镇静等级对上消化道出血内镜下治疗的影响。方法73例上消化道出血患者完全随机分为A、B组,2组均进行异丙酚静脉后实施内镜下止血治疗,其中A组镇静Ramsayscale为3～4分,B组镇静Ramsayscale为5～6分。结果2组病例均成功完成内镜下诊疗,操作成功率为100%。术中患者均有一过性血氧饱和度,血压下降,2组间比较差异无显著性,无严重并发症发生。B组胃、食管蠕动间隔时间明显少于A组(P>0.05)。B组治疗操作时间明显短于A组(P<0.05);B组内镜下治疗使用止血夹子数及止血夹子失误数均少于A组;两组间的初始止血率、再出血率、急诊手术率、死亡率差异均无显著性(P>0.05)。结论在应用适当预防措施的情况下,应用异丙酚镇静胃镜下诊疗无疑是安全的,同时应用异丙酚镇静达到Ramsayscale为5～6分时,实施胃镜下诊疗,其效果较佳。

Effet of anaesthesia depth on endoscopic hemostasia for upper gastrointestinal bleeding

Objective] To study the effect of anaesthesia depth on endoscopic hemostasia for upper gastrointestinal bleeding.Methods] 73 patients with upper gastrointestinal bleeding were divided into 2 groups named group A and group B,each group received endoscopic hemostasia under intravenous anaesthesia with propofol.Group A was treated under anaesthesia with Ramsay score of 3~4 while B was done with Ramsay score of 5~6.Results] 2 operations were finished and the success rate was 100%.There was 1 patient with hypotension and hypoxemia in each group in operation,but all episodes of hypotension and hypoxemia were transient.no statistical differences and severe complications were found.The internal time of gastric and esophageal peristalsis of group B was shorter significantly than that of group A(P >0.05).The operation time of group B was shorter significantly than that of group A(P <0.05).The hemoclips used or used with mistake of group B were all less than that of group A.there were no statistical difference between the 2 groups in primary hemostasia ratio,recurrent bleeding ratio,emergency operation ratio and death ratio.Conclusion] Under the proper pre-condition,it is safe to diagnose or treat through endoscopy under anaesthesia with propofol,and it returns some better results with ramsay score of 5~6.