【摘要】 目的  探討無痛胃鏡兩種方式——清醒鎮(zhèn)靜和靜脈麻醉下治療食管靜脈曲張或出血的可行性。 方法  2004年11月-2008年5月， 根據(jù)病情或患者要求，對13例患者行清醒鎮(zhèn)靜即靜脈推注咪達唑侖+芬太尼，30例行靜脈麻醉即靜脈推注咪達唑侖+丙泊酚。43例患者中36例行套扎治療，7例行1%乙氧硬化醇注射治療。 結(jié)果  43例均成功完成治療，急診止血率100%（11/11），治療后4周復(fù)查，顯效24例，占55.8%，有效17例，占39.5%，無效2例，總有效率95.3%。靜脈麻醉組術(shù)后遺忘度100%，清醒鎮(zhèn)靜組插鏡過咽和治療過程中發(fā)生惡心分別為76.9%、46.1%。兩組患者在治療過程中及治療后均未發(fā)生大出血。 結(jié)論  無痛胃鏡下行食管靜脈曲張治療安全、療效確切，以硬化劑注射治療者應(yīng)采用靜脈麻醉。
【Abstract】 Objective  To observe the effect of painless gastroscopy- conscious sedation and intravenous anesthesia on treating esophageal varices or bleeding. Methods  From November 2004 to May 2008, according to the disease condition or patient′s requirements, anesthetists assessed 13 patients who underwent conscious sedation with the intravenous injection of midazolam + fentanyl; 30 patients underwent intravenous anesthesia with intravenous injection of midazolam+propofol. Thirty-six patients underwent set tie treatment, and seven underwent 1% aethoxysklerol injection therapy. Results  AN of the 43 patients completed the treatment successfully, and the emergency bleeding rate was 100% (11/11). Four weeks after the treatment, 24 cases had apparent therapeutic effect, accounting for 55.8%; 17 patients had effect, accounting for 39.5%; 2 patients had no effect; the total effective rate was 95.3%. The postoperative forgotten degree of the patients in intravenous anesthesia group was 100%. The nausea rate happened during the mirrors inserting and treatment in the conscious sedation group was 76.9% and 46.1%, respectively. No hemorrhage occurred in both of the tow groups. Conclusion  Painless endoscopic is safe and effective for esophageal varices. Intravenous anesthesia should be used in Sclerotherapy.

引用本文： 蔣地能,周俊. 無痛胃鏡下治療食管靜脈曲張療效觀察. 華西醫(yī)學(xué), 2010, 25(9): 1604-1606. doi: 復(fù)制