咪达唑仑联合不同剂量盐酸纳布啡用于 重度肥胖患者无痛胃镜检查的效果

Effect of Midtazolam Combined with Different Doses of Hydrochloride Novels for Severe Obesity Patients Undergoing Painless Gastroscopy Examination

摘要:

〔摘 要〕 目的：探讨咪达唑仑联合不同剂量盐酸纳布啡用于重度肥胖患者无痛胃镜检查的效果。 方法：选择南昌市 第五医院 2018 年 1 月至 2020 年 7 月期间接受无痛胃镜检查的 126 例重度肥胖患者，按随机数字表法分为对照组和观察 组，各 63 例。观察组应用 2.5 mg 纳布啡复合咪达唑仑；对照组应用 5 mg 纳布啡复合咪达唑仑。比较两组患者的镇痛与镇 静情况、苏醒时间、体动与并发症。 结果：两组患者在苏醒后 5 min 的视觉模拟评分法（VAS）评分、麻醉诱导后 2 min 的 Ramsay 镇静评分比较，差异无统计学意义（P ＞ 0.05）；在苏醒后 30 min 两组患者的 VAS 评分较苏醒后 5 min 下降，差 异具有统计学意义（P ＜ 0.05）；但苏醒后 30 min 两组患者的 VAS 评分比较，差异无统计学意义（P ＞ 0.05）。内镜入喉时， 两组患者的的 Ramsay 镇静评分均较麻醉诱导后 2 min 升高，差异具有统计学意义（P ＜ 0.05）；但内镜入喉时两组患者的 Ramsay 镇静评分比较，差异无统计学意义（P ＞ 0.05）。观察组患者的完全苏醒时间为（5.03 ± 1.04）min，短于对照组的 （5.50 ± 1.20）min，差异具有统计学意义（P ＜ 0.05）。两组患者均无严重体动发生，且一般体动的发生率比较，差异无 统计学意义（P ＞ 0.05）；观察组患者的并发症发生率为 7.94 %，低于对照组的 20.63 %，差异具有统计学意义（P ＜ 0.05）。 结论：重度肥胖患者行无痛胃镜检查应用 2.5 mg 或 5 mg 的盐酸纳布啡复合咪达唑仑均可有效镇静镇痛，体动发生情况少， 但低剂量的盐酸纳布啡可减少并发症的发生，且利于患者苏醒。

Abstract:

〔Abstract〕 ObjectiveTo investigate the effect of midazolam combined with different doses of Nalbuphine hydrochloride on painless gastroscopy examination in patients with severe obesity. Methods 120 patients with severe obesity undergoing painless gastroscopy examinatin in Nanchang Fifth Hospital from January 2018 to July 2020 were selected, and were divided into control group and observation group according to the random digital table, with 63 cases in each group. The observation group was applied 2.5 mg nalbuphine hydrochloride composite midazolam; the control group was used 5 mg nalbuphine hydrochloride composite midazolam. Compared the analgesic and sedative situation of the two groups, awakening time, physical movement and complications. Results There was no significant difference between the two groups in VAS score 5 min after awakening and Ramsay sedation score 2 min after anesthesia induction (P > 0.05). VAS scores of patients in both groups decreased 30 min after awakening compared with 5 min after awakening, and the difference was statistically significant (P < 0.05); However, there was no significant difference in VAS score between the two groups 30 min after awakening (P > 0.05). Ramsay sedation score of patients in both groups was higher than that 2 min after anesthesia induction, with statistically significant difference (P < 0.05); However, there was no statistically significant difference in Ramsay sedation score between the two groups during endoscopic laryngeal entry (P > 0.05). The complete awakening time of the observation group was (5.03 ± 1.04) min, which was shorter than that of the control group (5.50 ± 1.20) min, and the difference was statistically significant (P < 0.05). There was no serious body movement in the two groups, and there was no significant difference in the incidence of general body movement (P > 0.05). The incidence of complications in the observation group was 7.94 %, lower than 20.63 % in the control group, and the difference was statistically significant (P < 0.05). Conclusion Severe obesity patients underoing painless gastroscopy examination applping 2.5 mg or 5 mg of namphhine hydrochloride composite midazolam can effectively calm the sedation, the body movement is small, but the low nalbuphine dose of hydrochloride can reduce the occurrence of complications, it is conducive to the patient to wake up.