目的：使患儿舒适、安全、无痛苦，内镜医师操作更准确、更快捷。方法采用瑞芬太尼、丙泊酚、阿托品联合用药，吸氧，心电监护，以及配备急救药品，气管插管等急救设备。结果112例患儿无痛胃镜检查时间为1.5~5min（平均3.2min），检查后1~7.5min（平均4.6min）清醒，检查中BP、HR、RR、SpO2基本平稳，有15例患儿血氧饱和度下降至90%以下，经处理后恢复98%以上；10例患儿出现恶心、躁动、呛咳，追加少量异丙酚后完成检查。所有患儿均顺利安全完成胃镜的检查或治疗。结论无痛胃镜检查是一种舒适、安全、有效、无不良后遗症，特别适合不合作、对胃镜检查有恐惧的儿童的上消化道检查或治疗。%Objective To make children with disease comfortable, safe and painless. The operation of endoscopic doctor is more accurate and quick. Methods The combined use of remifentanil, propofol and atropine. Get ready the ifrst aid equipment include oxygen, ECG monitoring, emergency medicine, trachea cannula and so on. Results The checking time of 112 cases of children with painless gastroscopy is 1.5-5 min(the average is 3.2 min). After checking the waking time is 1-1.75 min(the average is 4.6 min). In checking time, the BP, HR, RR and SpO2 is stable. The oxygen saturation of blood of 15 cases in them descend to below 90%, some of them recover to 98%after treatment. The 10 cases of them come to nausea, restlessness or bucking, the checking is acco-mplished after increasing the dose of propofol. All children ifnish the gastroscopy safely and successfully. Conclusion The painless gastroscopy is comfortable, safe, effective and no sequela. Especially for some children who will be unco-operative and afraid to checking and treatment in gastroscopy.
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