【摘要】 目的探讨丙泊酚复合纳布啡麻醉在老年肠道内镜黏膜下剥离（ESD）中的临床效果。方法老年肠道ESD手术患者116例,按随机数字表法分为对照组和治疗组,各58例。对照组静脉推注1.5 mg·kg^-1,持续输注舒芬太尼0.2μg·kg^-1·h^-1。治疗组静脉推注丙泊酚1.5 mg·kg^-1,纳布啡0.1 mg·kg^-1。比较两组麻醉效果、不同时间呼吸频率及心率、血压、血氧饱和度变化及不良反应发生率。结果治疗组一般体动、苏醒时间、疼痛程度与对照组差异无统计学意义（P>0.05）;治疗组手术5,10,30 min及手术结束时呼吸频率高于对照组（P<0.05）,心率、血压、血氧饱和度与对照组差异无统计学意义（P>0.05）;两组不良反应发生率差异无统计学意义（P>0.05）。结论丙泊酚复合纳布啡或舒芬太尼对老年肠道ESD手术患者麻醉效果相当,从安全角度考虑,推荐丙泊酚复合纳布啡进行麻醉。更多还原

【Abstract】 Objective To evaluate the clinical application of propofol combined with nalbuphine in elderly patients undergoing endoscopic submucosal dissection（ESD） anesthesia. Methods A total of 116 elderly patients undergoing ESD surgery were enrolled.They were divided into two groups according to the random number table（58 cases in each group）.The control group was given 1.5 mg·kg^-1propofol intravenously.And 0.2 μg·kg^-1·h^-1 sufentanil was given by an intravenous infusion pump continuously.The treatment group was administrated with propofol 1.5 mg·kg^-1and nabulphine 0.1 mg·kg^-1intravenously.The anesthesia effect, respiratory rate, heart rate, blood pressure, oxygen saturation and the incidence of adverse reactions were compared between the two groups. Results There was no significant difference in general body movement, recovery time and pain score between the treatment group and the control group（P>0.05）.The respiratory rate of the treatment group was significantly higher than that of the control group at 5, 10, 30 min and the end of the operation（P<0.05）.There was no significant difference in heart rate, blood pressure and oxygen saturation between the treatment group at 5, 10, 30 min and the end of surgery（P>0.05）.The incidence of adverse reactions in the treatment group was not significantly different from that in the control group（P>0.05）. Conclusion Propofol combined with nalbuphine or sufentanil is equivalent anesthesia effect in elderly patients with intestinal ESD.However, from a security perspective, the regime of propofol combined with nalbuphine is recommended for application in elderly patients undergoing intestinal ESD.更多还原