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1、临床麻醉与研究文章名首字母：GHIJKLMNlc0479静脉麻醉在内镜检查中的应用王震、雷勇静、杜筱玲静脉麻醉在内镜检查中的应用芜湖市第二人民医院麻醉科241000王震雷勇静杜筱玲摘要：目的：研究静脉麻醉药咪唑安定和异丙酚联合应用于内镜检查中的可行性和安全性。方法：ＡＳＡⅡ级以下，镇静组胃镜检查者60例、结肠镜检查者36例，同期普通胃镜60例、肠镜36例为对照组；观察在静脉麻醉下生命体征的变化,镇静效果分级、并发症发生率（呼吸抑制、血压下降、恶心、呕吐、咳嗽和躁动）以及用药总量、检查后清醒时间（
2、呼之睁眼、可回答问题）和离室时间，并与对照组比较。结果：镇静组效果分级在4～5级，对内镜操作无记忆，且在进境、退镜时血压、心率与入室时基本无异，而对照组在进镜时血压、心率有明显升高；两组比较（P〈0.05〉有显著性差异。镇静组恶心呕吐、咳嗽、躁动、咽部不适发生率分别为0、8.3％、10％、0，而对照组分别为38%、1.7％、28％、24％；镇静组清醒时间为7.86±2.21min,术毕室内留滞时间为18.25±3.56min，而对照组室内留滞时间为5.12±1.32min；胃镜总用药量咪唑安定2
3、±0.25mg，异丙酚100±20mg；肠镜咪唑安定2±0.25mg，异丙酚150±30mg；结论：静脉麻醉下的内镜检查是操作简单、安全可行的，其术毕室内留滞时间较普通内镜检查稍长,应由经验丰富的麻醉医师和内镜检查医师合作完成，在检查室内应常规配备急救药品和器械，以确保安全。关键词静脉麻醉咪唑安定异丙酚胃镜肠镜[Abstract]Objective:Studyingthefeasibilityandsafetyofjointapplicationofmidazolamandpropofoldur
4、ingendoscopicprocedures.Method:ＡＳＡⅡclassbelow,60casesofgastroscopyand36casesofcolonscopyinsedativegroupweregivenintravenousmidazolamandpropofol,incontrollinggroup,60casesofgastroscopyand30casesofcolonscopyweregivenroutineprocedures;thechangesofBloodp
5、ressure(BP),heartrate(HR),pulseoxygensaturation(SpO2),thegradeofsedationeffect,therateofcomplications(breathrepress,bloodpressuredescent,nausea,vomiting,coughandrestlesess),totaldose,thetimeofwaking(shoutitopeneyes,cananswerquestion)thetimeofleavingr
6、oominsedativegroupwerecomparedwithcontrollinggroup.Result:Insedativegroup,thegradeofsedationeffectisin4～5classes,nomemoryofexamination.enteringandbackingtheendoscopic,thechangeofbloodpressure,andheartrateisslight.Butincontrollinggroup,bloodpressurean
7、dheartrategoupobviouslywhenexamination.Comparingtwogroup（P〈0.05〉hassignificantdifference.Theincidenceofnauseaandvomiting,cough,restlesess,swallowdiscomfortinsedativegroup(0,8.3%,10%,and0,respectively)wasremarkablelowerthanthatofcontrolgroup(38%,17%,2
8、8%and24%,respectively,P<0.05);Insedativegroupawaketimeis7.86±2.21min,theindoorsstaystimeis18.25±3.56min,butthecontrollinggroupindoorsstaystimeis5.12±1.32min;GastroscopygrossstabilizeswithMidazolam2±0.25mg，Propofol100±20mg；Colonscopygrossstabilizeswit
