芬太尼联合异丙酚在食管静脉曲张套扎中的有效性和安全性分析

目的探讨芬太尼联合异丙酚用于食管静脉曲张套扎治疗的疗效和安全性。方法73例肝硬化患者分为芬太尼联合异丙酚组（Ⅰ组）、镇静剂组（Ⅱ组）和普通胃镜组（Ⅲ组），共进行114例次内镜下套扎术，比较各组胃镜操作时间、视野清晰度、术中不适反应和呼吸、心率、血压、血氧饱和度变化。结果Ⅰ组胃镜操作时间明显短于Ⅲ组（P〈0．05），Ⅰ组及Ⅱ组视野清晰度明显高于Ⅲ组（P〈0．05）。除Ⅰ组患者术中血压有一过性下降外（P〈0．01），各组的呼吸、心率、血氧饱和度无明显变化，但Ⅰ、Ⅱ组术中不适反应少。结论芬太尼联合异丙酚实行食管静脉曲张套扎术疗效良好，不适反应少。

Efficacy and safety of combined administration of fentany and propofol in endoscopic variceal ligation

Objective To evaluate the efficacy and safety of combined administration of fentany and propofol for endoscopic sedation in patients with esophageal varices. Methods Seventy-three patients with liver cirrhosis were randomly divided into three groups： fentanyl-propofol group （group Ⅱ）, sedation group （group Ⅱ） and conventional endoscopic ligation group （group Ⅲ ） ; 114 endoscopic ligations were performed in all patients. Operation time, legibility of visual field, respiration, heart rate, blood pressure, SPO2, and intraoperative adverse effects were compared among all groups. Results The operation time in group Ⅰ was significantly shorter than that in group Ⅲ （P〈0.05） ,but the legibility of visual field in groups Ⅰ and Ⅱ was superior to that in group Ⅲ （ P 〈 0.05）. The respiration, heart rate and SPO2 remained normal during operation in all groups except temporary hypotension in group Ⅰ （ P 〈 0.01 ）. The intraoperative adverse effects were fewer in groups Ⅰ and Ⅱ compared with group Ⅲ. Conclusion The combined sedation of fentanyl and propofol is effective and safe in endoscopic variceal ligation.