摘要
目的：评价Narcortrend监测在老年患者无痛肠镜肠道肿瘤筛查中的效果。方法：选择2015年3月至2015年12月进行肠镜肠道肿瘤筛查患者240例,65-75岁,其中男性130例,女性110例。随机分为A组、B组、C组,每组80例。麻醉方法采用靶控输入（target-controlled infusion,TCI）丙泊酚,使用麻醉深度监测仪（Narcortrend）监测麻醉深度,A组维持麻醉深度指数（narcortrend index,NI）值为D0（64-57）,即常规较浅麻醉,B组维持NI值为D1（56-47）,即常规中等深度麻醉,C组维持NI值为D2（46-37）,即常规深度麻醉。手术结束停止用药。记录患者入睡时间、苏醒时间、丙泊酚用量,及术中体动、高血压、低血压、心动过速、心动过缓、呼吸抑制的发生情况。结果：三组顺利完成手术,各组均未发生术中体动;B组相比于A组,C组,麻醉并发症发生率较低（χ2=6.337,P=0.038）。三组入睡时间、苏醒时间无明显差异（P〉0.05）。结论：无痛肠镜检查中,Narcortrend镇静NI值为D1（56-47）时比较适合老年患者。
Objective： To assess the sedation induced by propofol in painless enteroscopic intestinal tumor screening under narcotrend monitoring. Methods： 240 patients（ 130 male,110female） at age 65 - 75 years old which have undergone colonoscopy exam for intestinal tumor screening from March 2015 to December 2015 were participated in our study.The participants were randomized into 3 groups by computer： group A,group B,group C. Each group consists of 80 patients. During the anesthesia procedure,propofol is infused by TCI（ target-controlled infusion） while Narcortrend was used to monitor the sedative depth. For group A,the NI value is maintained at D0 level（ 64 - 57） which was a relatively lower anesthetic level. For group B,the NI value was maintained at D1 level（ 56 - 47） which was intermediate,while for group C,the NI value was maintained at D2 level（ 46 - 37） which was high. The infusion of propofol is ceased when the operation finished. The incidence of high and low pressure,tachycardia,bradycardia,respiratory inhibition and movement were recorded during the process of ranging from anesthesia induction to recovery. Results： Three groups successfully completed surgery without movement. The lowest incidence is maintained at D1 level（ P〈0. 05）. There was no difference for 3groups for the time of falling into sleep and awake（ P〈0. 05）. Conclusion： NI value at D1 colonoscopy exam is appropriate for elder patients.
出处
《肿瘤预防与治疗》
2016年第4期214-216,共3页
Journal of Cancer Control And Treatment
基金
四川省卫计委资助项目(150238)
关键词
肠镜
镇静深度
麻醉并发症
老年
肠道肿瘤
Colonoscopy
Depth of sedation
Anesthesia complications
old
intestinal tumor
