冠心病患者达克罗宁胶浆局麻下胃镜检查与无痛胃镜技术安全性比较

目的观察评估冠心病患者在达克罗宁胶浆局麻下行消化道内镜检查的安全性。方法 102例冠心病合并消化道疾病患者,随机入选异丙酚静脉麻醉组(A组,50例)和达克罗宁胶浆局部浸润麻醉组(B组,52例),观察两组患者血压(BP)、心率(HR)、心电图(ECG)、呼吸频率(R)、脉搏氧饱和度(SpO2)、检查时间、给药总量及药物其他不良反应。结果检查中房室传导阻滞发生率A组比B组低(P<0.05),其中B组2例检查后未恢复,但回病房监护半小时后消失,未发生Ⅱ度以上房室传导阻滞,ST段压低发生率B组高于A组,但差异无统计学意义(P>0.05),检查后均恢复至检查前水平;检查中2例患者原有室性早搏消失,A组1例患者新出现室性早搏,组间比较无统计学意义(P>0.05)。检查时间A组较B组长(P<0.01)。结论冠心病患者达克罗宁胶浆麻醉下行胃镜检查同无痛技术比较未明显增加心血管反应,且操作安全,使用方便,明显缩短上消化道内镜检查的时间。

Comparing the security of gastroscope endoscopy with Dyclonine mortar local anesthesia with painless gastroscope endoscopy technology in patients with coronary heart disease and gastrointestinal disease

Objective To observe the security of gastrointestinal endoscopy after local anesthesia with Dyclonine mortar in patients with coronary heart disease and disease of digestive tract.Methods 102 patients with coronary heart disease and gastrointestinal disease were randomly divided into propofol intravenous anesthesia group(group A,n=50) and Dyclonine local anesthesia group(B group,n=52).The blood pressure(BP),heart rate(HR),electrocardiogram(ECG) and respiratory rate(R),pulse oxygen saturation(SpO2),the time of checking and the total dose and drug adverse reactions were compared between these two groups.Results Group A had lower incidence of atrioventricular block than Group B(P<0.05).The atrioventricular block of two patients in Group B was not restored during examination,but disappeared after half an hour in CCU and never happened more than twice again.The ST segment depression incidence of group B was higher than in group A,but there was no statistical difference between them(P>0.05).All of them returned the pre-examination level.And previous premature ventricular contractions in 2 patients disappeared during examination.Another patient in Group A was diagnosed with premature ventricular contractions.However,there was no statistical difference between the two groups(P>0.05).Group A needed more time to check up than Group B did(P<0.01).Conclusion Contrast to painless gastroscope endoscopy technology, the gastrointestinal endoscopy after local anesthesia with Dyclonine mortar in patients with coronary heart disease and disease of digestive tract has no significant cardiovascular response.The operation is safe and easy to use and also significantly reduce the time of operation.