无痛气管镜检查的优越性及安全性评价  

The superiority and security of the painless bronchoscopy under general anesthesia

作　　者：梅爱红[1] 谈敏[1] 李譞[1] 彭爱梅[1] 颜正茂[1] 傅佩芳[1] 

机构地区：[1]同济大学附属第十人民医院呼吸内科,上海200072

出　　处：《同济大学学报（医学版）》2011年第2期72-75,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨无痛支气管镜检查方法的优越性及安全性。方法将88例患者随机分为A、B两组。A组42例为局部麻醉组,用2%利多卡因咽部、气管局部麻醉;B组46例为无痛组(全身麻醉),给予异丙酚(2.00±0.56)mg/kg,芬太尼50～100μg,术中静脉滴注异丙酚维持麻醉。结果 A组患者术中收缩压、舒张压较术前升高,B组患者术中收缩压、舒张压较术前下降,且B组的血压变化变化较A组更明显(P<0.05)。两组患者脉搏氧饱和度较术前均有所降低,但B组的下降较A组的更明显(P<0.05)。A组患者术中心率加快,B组患者术前、术中心率无明显变化(P>0.05)。A组术中呛咳、体动发生率、术后不良记忆明显高于B组(P<0.05)。B组患者能够接受复查人数多于A组(P<0.05)。结论无痛支气管镜检查麻醉质量好,成功率高,安全,并发症少,不良记忆少,患者易于接受,值得临床推广。Objective To investigate the superiority and security of the painless bronchoscopy under general anesthesia.Methods Eighty-eight patients were randomly divided into two groups,with 42 patients in group A under local anesthesia given 2%lidocaine in throats and local trachea and 46 patients in group B under general anesthesia,given propofol（2.00±0.56） mg/kg,fentanyl 50-100μg and intravenous infusion of propofol to maintain anesthesia.Results Compared with preoperative situations, systolic blood pressure（SBP） and diastolic blood pressure（DBP） levels increased in group A during bronchoscopy but decreased in group B.The decrease was more significant in group B（P0.05）.Pulse oxygen saturation decreased in both groups with more significant change in group B（P0.05）. Patients of group A underwent heart rate speedup,while no significant differences were found in group B（P0.05）.The incidence of intraoperative cough,body movement and postoperative bad memory was also higher in group A（P0.05）.More patients in group B were willing to accept a re-bronchoscopy（P0.05）.Conclusion General anesthesia with propofol uniting fentanyl during bronchoscopy is achieved with satisfactory effects.It has better quality,higher success rate,less syndromes,less bad memories,more acceptability by patients and it deserves further application in clinic.

关 键 词：气管镜 全身麻醉 优越性 安全性 

分 类 号：R768.1[医药卫生—耳鼻咽喉科]