复合麻醉在老年患者支气管镜检查中的应用  

Application of the combined anesthesia to bronchoscopy in elderly patients

作　　者：董彦平[1,2] 

机构地区：[1]单县中心医院 [2]济宁医学院附属湖西医院,山东单县274300

出　　处：《齐鲁护理杂志》2013年第14期8-10,共3页Journal of Qilu Nursing

摘　　要：目的:探讨复合麻醉(丙泊酚联合盐酸瑞芬太尼分次静脉注射)在老年患者支气管镜检查中的应用效果。方法:将40例老年患者随机分为观察组与对照组各20例。检查前两组均雾化吸入2%利多卡因10 min,对照组待雾化吸入结束后进行检查;观察组雾化吸入结束后,静脉注射丙泊酚1 mg/kg,患者意识消失后再给予盐酸瑞芬太尼0.3μg/kg静脉注射,注药完毕2min后开始检查。结果:观察组患者检查中咳嗽例数、被迫终止检查例数、发生并发症例数均少于对照组,肢体活动评分、呼吸抑制评分优于对照组,患者与医生对护理工作的满意度高于对照组(P<0.01);观察组患者支气管镜进入声门时、入声门后3 min、取活检时、清醒时血压、心率、SpO2数值及检查中最低值均优于对照组(P<0.05)。结论:对接受支气管镜检查的老年患者进行充分的术前准备和有效的个体化护理可保证检查顺利、安全进行。Objective： To investigate the effect of the combined anesthesia （fractionally intravenous injection with propofol combined with remifentanil hydrochloride） in bronchoscopy for elderly patients. Methods ：40 elderly patients were randomly divided into the observa- tion group and the control group （20 cases in each group）. The patients in both groups were given nebulized inhalation of 2% lidoeaine for 10 minutes before bronehoscopy. The patients in the control group received the examination after the completion of inhalation;the patients in the observation group were given intravenous injection of propofol 1 mg/kg after the the completion of inhalation and then given remifen- tanil 0.3 μg/kg by intravenous injection when the patients lost consciousness, the eamination began in 2 minutes after the injection. Re- sults ： The frequency of cough of the patients during the examination, the cases of forced termination during the examination and the inci- dence of complications were less and fewer in the observation group than the control group ; the scores of physical movement and respiratory depression were superior and less in the observation group to the control group;the patient~ satisfaction with doctors and nursing service was higher in the observation group than the control group （P 〈 0.01） ;the blood pressure, heart rate and SpO2 value was better in the ob- servation group than the control group during and after the examination （ P 〈 0.05 ）. Conclusion： The fully preoperative preparation and the effective individualized nursing care can ensure smooth operation and safety of the patients in bronchoscopy for elderly patients.

关 键 词：盐酸瑞芬太尼 丙泊酚 老年患者 支气管镜检查 护理 

分 类 号：R473.6[医药卫生—护理学]