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1. 重庆医科大学附属第一医院急诊科
2. 重庆医科大学附属第一医院中心ICU
纸质出版日期:2010,
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[1]余应喜,周发春.床旁无痛内镜下胃、空肠造口术对危重病人的影响临床研究[J].重庆医科大学学报,2010,35(07):1080-1082.
YU Ying-xi, et al. Clinical research on percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy without pain at bedside in critical patients[J]. Journal of Chongqing Medical University, 2010,35(7):1080-1082.
[1]余应喜,周发春.床旁无痛内镜下胃、空肠造口术对危重病人的影响临床研究[J].重庆医科大学学报,2010,35(07):1080-1082. DOI: 10.13406/j.cnki.cyxb.2010.07.044.
YU Ying-xi, et al. Clinical research on percutaneous endoscopic gastrostomy and percutaneous endoscopic jejunostomy without pain at bedside in critical patients[J]. Journal of Chongqing Medical University, 2010,35(7):1080-1082. DOI: 10.13406/j.cnki.cyxb.2010.07.044.
目的:探讨异丙酚在危重病人床旁无痛经皮内镜下胃造口术(Percutaneous endoscopic gastrostomy
PEG)和经皮内镜下空肠造口术(Percutan eousendoscopic jejunostomy
PEJ)术中、术后对危重病人的影响。方法:38例重庆医科大学附属第一医院中心ICU2006年8月至2008年12月需要实施PEJ、PEG的危重病人随机分为异丙酚组(P组)和地西泮复合咪达唑仑组(DM组)
监测并记录患者术前10min至术后Ramsay≤Ⅱ级前全程持续监测心电波形、呼吸频率(Breath
Br)、外周血氧饱和度(SPO2)和血压。记录手术持续时间
苏醒时间
以及手术30min后患者对手术过程的主观回忆。结果:P组术中心率(Heartrate
HR)(72.20±8.96)次/min和B(r16.72±8.46)次/min降低较DM组明显
SPO(294.87±3.52)%优于DM组;术后10minP组HR(73.89±10.42)次/min和收缩压(Systolic blood pressure
SBP)(117.63±8.02)mmHg低于DM组
SPO(298.76±1.04)%较DM组高;P组的手术持续时间和苏醒时间较DM组缩短(P<0.05)
躁动、恶心、呕吐和呛咳等术中不良反应和对手术痛苦回忆亦少于DM组(P<0.05)。结论:在危重病人中开展无痛PEJ、PEG效果满意
异丙酚能够作为首选辅助药物
有利于减轻本治疗对患者造成的不良刺激
减少危重患者机体不必要的应激反应。
Objective:To investigate the effects of critical patients who were treated with percutaneous endoscopic gastrostomy(PEG)or percutaneous endoscopic jejunostomy(PEJ)with propofol at bedside.Methods:Tirty-eight patients
who were admitted in the ICU of the first affiliated hospital of the Chongqing medical university between August 2006 and December 2008
were randomly divided into P-group (propofol group)and DM-group.(diazepam combined with midazolam group).Electrocardio waveform
breath(Br)
SPO2 and blood pressure were monitored and recorded from 10 min before operation to the time with the patients’Ramsay≤Ⅱafter operation (postoperative monitoring≥10min).And recorded the persistence time of operation
awaken time and subjective anamnesis were recorded at 30min after operation.Results:In the operation
the heart rate(HR)in P-group was(72.20±8.96)/min
which was significantly decreased compared with DM-group.The Br was(16.72±8.46)/min in P-group during operation
which was significantly decreased compared with DM-group
and the SPO2 in P-group was(94.87±3.52)%
which was significantly increased compared with DM-group(P<0.05).At 10 min after operation
the heart rat(eHR)in P-group was(73.89±10.42)/min
which was significantly lower compared with DM-group;the systolic blood pressure(SBP)in P-group was(117.63±8.02)mmHg which was significantly lower compared with DM-group and the SPO2 of P-group was(98.76±1.04)%which was significantly higher compared with DM-group(P<0.05).The persistence time of operation(26.83±5.84)min which was signifi cantlyshorter compared with DM-group(P<0.05).The awaken time of P-group was(7.62±2.47)min
which was significantly quicker compared with DM-group(P<0.05).The adverse effects inoperation
including restlessness
bucking nausea and vomitting
were significantly not so many in P-group as DM-group(P<0.0 And the painful anamnesis to the operation of P-group was significantly not so many as DM-group(P<0.05).Conclusion:It was satis to apply propofol for PEJ/PEG without causing pain in critical patients.Propofol could be regarded as the leader ancillary drug in treatment.And it could lessen the harmful stimulus of the operation on the patients
thereby it is helpful lessen the uncalled-for st reactions.
异丙酚镇静危重病人经皮内镜下胃造口术经皮内镜下空肠造口术
propofolSedationCritical patientsPercutaneous endoscopic gastrostomyPercutaneous endoscopic jejunostomy
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