二异丙酚静脉麻醉在高龄患者行经皮内镜下胃造口术的探讨

摘要

目的 高龄患者因神经系统等疾患,为加强营养多需行胃造口术,普通胃镜检查治疗时,因机械性刺激可能引起患者血压迅速升高、心律失常等,导致围手术期并发症发生率与病死率升高,寻找一种安全有效的检查治疗方法,势在必行.文中探讨二异丙酚(Disoprofol )静脉麻醉下,为高龄患者行经皮内镜下胃造口术(percutaneous endoscopic gastrostomy PEG)的安全性.方法 20例高龄患者二异丙酚静脉麻醉后行PEG,观察术前、术中、术后的心率、平均动脉压(mean artery pressure,MAP)、呼吸、脉氧饱和度、反应和思维能力的变化以及有无并发症的发生.结果 平均置管时间为(17.10±3.14)min,置管成功率100%,术中、术后心率、MAP、呼吸、脉氧饱和度、反应和思维能力同术前无显著差异,未发生与麻醉、置管有关的并发症.结论 在高龄患者应用二异丙酚静脉麻醉行PEG,患者无痛苦,对呼吸、循环无明显抑制作用,诊疗成功率高,安全可靠.%Objective Most aged patients with diseases of the nervous system receive nutrition by percutaneous endoscopic gastrostomy ( PEG) . This study was to investigate the safety of PEC under intravenous Disoprofol anesthesia in aged patients. Methods Twenty aged patients underwent PEG under intravenous Disoprofol anesthesia and were observed for the changes of heart rate,blood pressure, respiration, arterial oxygen saturation, thinking and reaction abilities. and the occurrence of complications before, during and after the operation. Results The average time of intubation was (17. 10 ±3. 14) min, with a success rate of 100％ . The intra-and post-operative heart rate, blood pressure, respiralion, arterial oxygen saturation, and thinking and reaction abilities showed no marked differences from the preoperative ones. And there were no complications associated with anesthesia and intubation. Conclusion PEG under intravenous Disoprofol anesthesia gives no pain and has no obvious inhibitory effect on respiration and circulation,and therefore is safe and reliable far aged patients.