老年患者局部麻醉下行支气管镜检查的安全性及耐受性评价  

Evaluation of safety and tolerance of bronchoscopy under local anesthesia in senile patients

作　　者：余荣环[1] 胡斌[1] 陈弘群[1] 黄运平[1] 薄维娜[1] 

机构地区：[1]上海市徐汇区中心医院呼吸内科,200031

出　　处：《中华实用诊断与治疗杂志》2009年第10期965-967,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的:探讨老年患者局部麻醉下行支气管镜检查的安全性和耐受性。方法:行支气管镜检查或治疗的120例患者按年龄分为≥65岁组(60例)和<65岁组(60例),术前测定紧张度,术前、术中检测血压、心率、血氧饱和度,对支气管镜进入声门难易程度、恶心、窒息、咳嗽进行评分,并进行比较。结果:(1)2组患者在支气管镜进入声门时,左、右支气管检查中血压和心率均较术前升高,≥65岁组收缩压升高较<65岁组明显(P<0.05),心率增快2组比较差异无统计学意义(P>0.05);(2)术前紧张度≥65岁组低于<65岁组(P<0.01);(3)≥65岁组较<65岁组支气管镜进入声门容易(P<0.05);(4)≥65岁组愿意再次接受检查率为56.7%(34/60),<65岁组为46.7%(28/60),2组比较差异无统计学意义(P>0.05);(5)≥65岁组操作困难9例(15.0%),<65岁组操作困难10例(16.7%),失败4例(6.7%),2组比较差异无统计学意义(P>0.05)。结论:老年患者局部麻醉下行支气管镜检查安全,患者耐受性良好。Objective To evaluate the safety and tolerance of bronchoscopy under local anesthesia in senile patients.Methods One hunderd and twenty patients receiving bronchoscopy were divided into ≥65-year-old group and 65-year-old group,60 patients each.The tension score of patients were assessed before operation with VAS.Blood pressure,heart rate and SpO2 were monitored continuously before,during and after the bronchoscopy.The difficulty level of the operation,nausea,suffocation and cough of patients also were evaluated with VAS method.Resluts（1）Blood pressure and heart rate increased when the bronchoscope went through glottis and during the operation both in two groups,but the increase of systolic plessure was more significant in ≥65-year-old group.The increase of heart rate had no statistic difference between two groups（P0.05）.（2）The tension score in ≥65-year-old group was lower than that in 65-year-old group before the operation（P0.01）.（3）It was easier to go through glottis in ≥65-year-old group（P0.05）.（4）Thirty-four patients（56.7%）were willing to receive bronchoscopy again in ≥65-year-old group and 28 patients（46.7%）in 65-year-old group（P0.05）.（5）In ≥65-year-old group,bronscopy was difficult to perform in 9 patients（15.0%）.In 65-year-old group,bronscopy was difficult to perform in 10 patients（16.7%）and failed in 4 patients（6.7%）.There was no statistic difference between two groups（P0.05）.Conclusion It is relatively safe and well tolerable in senile patients to take bronchoscopy under local anesthesia.

关 键 词：支气管镜 局部麻醉 老年 

分 类 号：R614[医药卫生—麻醉学] R768.1[医药卫生—外科学]