靶控输注与微泵输注丙泊酚用于小肠镜检查的比较研究

摘要

Objective Observation the efifcacy and safety use micro-target-controlled infusion of propfol and infusion pump for double-balloon enteroscopy. Methods 40 cases of ASA Ⅰ-Ⅱ patients who undergo double-ballon enter oscopy. 22-60 years and weight 45-70 kg were divided into target-contrubed group (TCI pump) and micro-pump (DA-speed micro-pump) randomly and 20 patients in each group. Which were used to target controlled infusion pumps and micro-infusion of propofol in two ways. Target controlled group infusion of propfol with plasma drug concentration in target, target concentration 2.5-4 μg/mL micro-pump group constant infusion of propofol 4-8 mg/(kg•h) both groups were treated in body movement, cough reaction to adjust the output target plasma concentration. Recording before administration (T0), after administration of 1 min (T1), after treatment 5min (T2), intraoperative 1h (T3) and awakening (T4) of HR, MAP, RR, SpO2; observed induction time, recovery time. Microscopic examination time, total propofol dosage, adverse reaction rates and satisfaction.Results All patients could complete the operation. Micro-pump after administration 1 min (T1) compared with before administration (T0), MAP, HR, RR were decreased (P<0.05), after administration 5 min (T2) intraoperative 1 h (T3) and awaking (T4) in both groups HR, MAP, RR were not statistically signiifcant (P>0.05). Two group’s SpO2, induction and recovery time, microscopic examination time and satisfaction were not statistically (P>0.05). Propofol dosage and the total incidence of adverse reactions of target-controlled group less than micro-pump group (P>0.05). Conclusion Target-controudd infusion of propofol induction of anesthesia smooth, anesthetic effete is good which can reduce the amount of propofol and adverse reactions.%目的：观察靶控输注与微泵输注丙泊酚用于双气囊小肠镜检查的效果和安全性。方法40例ASAⅠ~Ⅱ级拟行双气囊小肠镜检查的患者，年龄22~60岁，体质量45~70kg，随机分为靶控组（TCI泵）和微泵组（恒速微泵），每组20例。分别采用靶控输注和微泵输注两种方式输注丙泊酚。靶控组以血浆药物浓度为靶目标进行靶控输注丙泊酚，靶浓度为2.5~4μg/mL。微泵组以丙泊酚4~8mg/(kg•h)恒速输注。两组术中均视体动、呛咳反应调整输出血浆靶浓度。记录患者给药前（T0）、给药后1min（T1）、给药后5min（T2）术中1h（T3）和苏醒时（T4）的HR、MAP、RR、SpO2的变化；观察诱导时间、苏醒时间、镜检时间、丙泊酚总用量、不良反应发生率及满意度。结果所有患者均能完成操作，微泵组给药后1min（T1）MAP、HR、RR较给药前（T0）下降（P＜0.05），靶控组MAP、HR、RR下降轻，两组比较有统计学意义（P＜0.05）。给药后5min（T2）术中1h（T3）和苏醒时（T4）两组的HR、MAP、RR比较无统计学意义（P＞0.05）。两组SpO2、诱导、苏醒时间、镜检时间及满意度无统计学意义（P＞0.05）。靶控组丙泊酚总用量及不良反应发生率少于微泵组（P＜0.05）。结论靶控输注丙泊酚麻醉诱导平稳，术中麻醉效果好，可减少丙泊酚的用量和不良反应。