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目的:评价右美托咪定联合依托咪酯诱导在老年患者结肠镜检查中应用的安全性和有效性。方法:选择结肠镜检查老年患者60例,随机分为芬太尼+丙泊酚组(F组)和右美托咪定+依托咪酯组(D组),每组30例。观察并记录各时点的平均动脉压(MAP)、心率(HR)、血氧饱和度(Sp O2)、呼吸频率(RR),记录术中追加丙泊酚量;清醒时间;术中因疼痛身体四肢扭动例数、呼吸抑制例数,术中术后肌阵挛、恶心呕吐、头晕头痛例数。结果:术中F组患者MAP、Sp O2、HR、RR下降低于D组(P<0.05);D组呼吸抑制发生率低于F组(P<0.05);两组术中身体四肢扭动、追加丙泊酚量、清醒时间差异无统计学意义(P>0.05);F组肌阵挛发生率低于D组(P<0.05);两组术中及术后恶心呕吐、头晕头痛差异无统计学意义(P>0.05)。结论:右美托咪定复合依托咪酯可用于老年患者无痛肠镜,麻醉效果好,术中患者生命体征稳定。
Objective: To evaluate the safety and efficacy of dexmedetomidine combined with etomidate in the treatment of colonoscopy in elderly patients. Methods: Sixty elderly patients undergoing colonoscopy were selected and randomly divided into fentanyl + propofol group (F group) and dexmedetomidine + etomidate group (D group), with 30 cases in each group. The mean arterial pressure (MAP), heart rate (HR), oxygen saturation (Sp O2) and respiratory rate (RR) at each time point were observed and recorded. The amount of propofol added during recording was recorded. Body limbs twisting cases, respiratory depression cases, postoperative myoclonus, nausea and vomiting, dizziness and headache cases. Results: The decrease of MAP, Sp O2, HR and RR in group F during operation was lower than that of group D (P <0.05). The incidence of respiratory depression in group D was lower than that of group F (P <0.05) (P> 0.05). The incidence of myoclonus in group F was lower than that in group D (P <0.05). The differences of nausea and vomiting, dizziness and headache between the two groups were not statistically significant No statistical significance (P> 0.05). Conclusion: Dexmedetomidine combined with etomidate can be used in elderly patients with painless colonoscopy, good anesthesia, intraoperative vital signs stable.