文章摘要
陶飞雪,夏书江,高红霞,卜小凤,童慧慧.预输液体对无痛肠镜检查过程中血流动力学的影响[J].中国临床保健杂志,2020,23(2):278-281.
预输液体对无痛肠镜检查过程中血流动力学的影响
Effect of pre-delivery fluid on hemodynamics during painless enteroscopy
投稿时间:2019-10-16  
DOI:10.3969/J.issn.1672-6790.2020.02.035
中文关键词: 血流动力学  胃肠内窥镜  麻醉和镇痛  药物相关性副作用和不良反应
英文关键词: Painless enteroscopy  Anesthetic  Blood Flow Dynamics  Pre-delivery Fluid 〖FL
基金项目:安徽省自然科学基金项目(1804h08020272 )
作者单位E-mail
陶飞雪 安徽医科大学附属巢湖医院护理部,巢湖 238000 tfx2366909@163.com 
夏书江 安徽医科大学附属巢湖医院麻醉科,巢湖 238000 xsj2366909@163.com 
高红霞 安徽医科大学附属巢湖医院内镜中心,巢湖 238000  
卜小凤 安徽医科大学附属巢湖医院内镜中心,巢湖 238000  
童慧慧 安徽医科大学附属巢湖医院内镜中心,巢湖 238000  
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中文摘要:
      目的 观察预输液对无痛肠镜检查过程中血流动力学的影响。方法 选择ASAⅠ—Ⅲ级需做无痛肠镜检查的患者100例,按随机数字表法分为预输液组(Ⅰ组)和对照组(Ⅱ组),每组50例;Ⅰ组在检查前预输入乳酸钠林格氏液10 mL/kg,Ⅱ组不输任何液体,监测血压、心率(HR)、心电图、血氧饱和度(SpO2),面罩吸氧4~6 L/min,静脉推注丙泊酚和瑞芬太尼混合液,首次缓慢推入丙泊酚的量为1.5~2 mg/kg,患者睫毛反射消失后肠镜检查,术中出现体动时静脉追加丙泊酚混合液2~3 mL,退镜时停注麻醉药。观察指标:推药前(T0)、推药后即刻(T1)、推药后4 min(T2)、结束时(T3),苏醒(呼之能睁眼)时(T4)的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)、HR、SpO2,苏醒后的恶心呕吐、头晕等情况。结果 与T0时比较,T1、T2、T3、T4时两组SBP、DBP、MAP、HR均明显降低(P<0.05)。与Ⅱ组比较,T1、T2、T3、T4时Ⅰ组SBP、DBP、MAP均明显高于Ⅱ组,HR慢于Ⅱ组(P<0.05);Ⅰ组低血压、恶心呕吐、头晕发生率明显低于Ⅱ组(P<0.05)。结论 预输入乳酸钠林格氏液10 mL/kg,患者无痛肠镜检查过程中血流动力学更加稳定,苏醒后恶心呕吐发生率更低。
英文摘要:
      Objective To observe the effect of pre-infusion on hemodynamics during painless colonoscopy.Methods A total of 100 patients with ASA Ⅰ-Ⅲ who needed painless colonoscopy were randomly divided into two groups:pre-infusion group (Ⅰ) and control group (Ⅱ),and there were 50 patients in each group.In group Ⅰ,sodium lactate Ringer's solution was pre-infused with 10ml/kg,and group Ⅱ was not infused with any liquid.Then BP,HR,ECG,SpO2 were monitored;mask oxygen uptake was 4-6 L/min;propofol and remifentanil mixture were injected intravenously;the amount of propofol was 1.5-2 mg/kg for the first time,and intestinal microscopic examination was performed after the eyelash reflex disappeared.In the procedure,2-3 mL of propofol mixed solution was added to the vein,and the anesthetic was stopped at the time of returning.Observation indicators included SBP,DBP,MAP,HR,SpO2 [Before pushing medicine (T0),immediately after the drug (T1),4 min after the administration (T2),at the end (T3),waking up (Shouting can open eyes) (T4)],and the nausea,vomiting,dizziness after waking.Results Compared with T0,at T1,T2,T3,T4,SBP,DBP,MAP significantly decreased in both groups (P<0.05).Compared with group Ⅱ,SBP,DBP,MAP,HR in group I were significantly higher than those in group Ⅱ;HR in group I was slower than that in group Ⅱ,and the incidence of hypotension,nausea,vomiting and dizziness in group Ⅰ was significantly lower than that in group Ⅱ (P<0.05),and the incidence of hypotension,nausea,vomiting and dizziness in group Ⅰ was significantly lower than that in group Ⅱ (P<0.05).Conclusion The blood flow dynamics is more stable in the process of painless enteroscopy,and the incidence of nausea and vomiting after recovery is lower with 10 mL/kg of Ringer's solution pre-infusion.
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