吸毒患者胃镜检查的丙泊酚麻醉效果观察

Effect of Propofol anesthesia in gastroscopy for drug addicts

摘要:

目的分析丙泊酚用于吸毒患者胃镜检查的现状。方法选取2011 年11 月-2017 年6 月该院消化科门诊及急诊收治的需接受胃镜检查的吸毒吞食异物患者42 例，随机分为观察组（丙泊酚麻醉）和对照组（非麻醉），观察两组患者循环及呼吸系统相关各项指标，对比两组患者手术时间、出现插管失败需拔管情况，以及与手术操作、麻醉用药相关的不良反应、手术耐受情况。结果观察组患者的耐受率为90.48%，高于对照组的4.76%（P <0.05）。观察组患者心率及呼吸频率在T1、T2和T3时间的波动幅度小于对照组。观察组患者胃镜手术 操作时间为（5.36±2.02）min，对照组操作时间为（8.84±1.97）min，观察组患者手术时较短（P <0.05）；观察组患者拔管率为0.00%，低于对照组的28.57%（P <0.05）。两组患者的高血压、低血压、心动过速、心动过缓、呼吸抑制发生率比较，差异无统计学意义（P >0.05），观察组患者戒断反应发生率低于对照组（ P<0.05）。结论丙泊酚用于吸毒患者的胃镜麻醉效果较好，麻醉过程中患者自觉不适感低，耐受性佳，安全性有保障，值得临床推广应用。

Abstract:

Objective To analyze the application status of Propofol for gastroscopy in drug users, and to guide the anesthesia of gastroscopy in drug addicts. Methods From January 2014 to December 2016, 42 patients who were treated in the Outpatient Department of Gastroenterology and Emergency Department of our hospital because of taking drugs or swallowing foreign bodies were required to undergo gastroscopy. They were randomly divided into observation group (Propofol anesthesia) and control group (no anesthesia). The circulatory system and respiratory system related indicators were observed. The surgery time, extubation after failed intubation and surgical operation, anesthesia-related adverse reactions and surgical tolerance were compared between the two groups. Results The tolerance rate was 90.48% in the observation group, which was significantly higher than 4.76% in the control group (P < 0.05). The fluctuation amplitude of HR and RR at T2, T3 and T4 was lower than that in the control group, and the data remained relatively stable. The duration of operation [(5.36 ±2.02) min] in the observation group was shorter than that [(8.84 ±1.97) min] in the control group (P < 0.05). The extubation rate of the observation group (0.00%) was significantly lower than 28.57% of the control group (P < 0.05). There was no statistical difference in the rate of hypertension, hypotension,tachycardia, bradycardia or respiratory depression (P > 0.05). The incidence of withdrawal reaction in the observation group was lower than that in the control group, the difference was statistically significant (P < 0.05). Conclusions Propofol is better for endoscopic anesthesia in drug users. During anesthesia, the patients have a low sense of discomfort, good tolerance and safety. It is worthy of clinical application.