清醒镇静与深度镇静在食管胃底静脉曲张内镜诊疗术的麻醉效果及安全性分析

摘要 目的：研究在清醒镇静与深度镇静下实施食管胃底静脉曲张内镜诊疗术的麻醉效果及安全性分析。方法：选取在我院2020年5月至2022年5月收治的94例食管胃底静脉曲张患者，按照随机数字表法将静脉曲张患者分为对照组和观察组，每组47例。对照组采用清醒镇静（咪达唑仑+芬太尼），观察组采用深度镇静在对照组基础上增加丙泊酚。观察对照组与观察组手术治疗时患者基生命体征变化以及手术治疗后的麻醉效果及安全性。比较两组患者治疗后治疗后的总有效率。结果：观察组总有效率显著高于对照组，差异具有统计学意义（P<0.05）。观察组出院时间、麻醉达标时间及术后拔管时间显著小于对照组，差异具有统计学意义（P<0.05）。各时间点实验组患者HR相比差异无显著性（P＞0.05）。在T2，T3，T4时，实验组患者MAP、HR均较对照组显著降低（P＜0.05）。两组患者手术时Ramsay评分和术后满意度比较，两组患者均无统计学差异。对照组和观察组不良反应发生率分别为12.75%和8.49%，两组比较差异无统计学意义（P>0.05）。结论：深度镇静对于食管胃底静脉曲张行内镜诊疗疗效显著而且安全可靠，疗程短，见效快，恢复快，患者接受程度高,提高治疗成功率，值得进行推广。

Anesthetic Effect and Safety Analysis of Conscious Sedation and Deep Sedation in Endoscopic Diagnosis and Treatment of Esophageal and Gastric Varices

ABSTRACT Objective: To study the anesthesia effect and safety analysis of endoscopic diagnosis and treatment of esophageal and gastric varices under conscious sedation and deep sedation. Methods: 94 patients with esophageal and gastric varices admitted to our hospital from May 2020 to September 2021 were selected and randomly divided into a control group and an observation group using a random number table method, with 47 patients in each group. The control group received conscious sedation(midazolam+fentanyl), while the observation group received deep sedation with propofol added to the control group. Observe the changes in basic vital signs of patients during surgical treatment, as well as the anesthesia effect and safety after surgical treatment in the control group and observation group. Compare the total effective rate of two groups of patients after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group, and the difference was statistically significant(P<0.05). The discharge time, anesthesia compliance time, and postoperative extubation time of the observation group were significantly shorter than those of the control group, with statistical significance(P<0.05). There was no significant difference in HR between the experimental groups at different time points(P>0.05). At T2, T3, and T4, the MAP and HR of the experimental group patients were significantly reduced compared to the control group(P<0.05). There was no statistically significant difference in Ramsay scores during surgery and postoperative satisfaction between the two groups of patients. The incidence of adverse reactions in the control group and the observation group was 12.75% and 8.49%, respectively, with no statistically significant difference between the two groups(P>0.05). Conclusion: Deep sedation has a significant and safe therapeutic effect on endoscopic diagnosis and treatment of esophageal and gastric varicose veins, with a short course of treatment, fast response, fast recovery, high patient acceptance, and improved treatment success rate. It is worth promoting.