不同麻醉方式对经支气管镜钳检活检相关气胸发生率的影响  

Effect of different methods of anesthesia on the incidence of pneumothorax intrans bronchial forceps biopsy

作　　者：林宇鹏[1] 袁小玲[1] 

机构地区：[1]广东省中山市人民医院,528400

出　　处：《检验医学与临床》2014年第A01期85-87,共3页Laboratory Medicine and Clinic

摘　　要：目的通过对比单纯表面麻醉及表面麻醉联合静脉麻醉下（以下称联合麻醉）进行经支气管镜钳检活检相关气胸的发生率，以评估后者的安全性。方法选取2012年8～10月及2013年8～10月在支气管镜室行经支气管镜钳检活检的患者共452例，其中表面麻醉组198例，联合麻醉组254例，术后行胸片或胸部CT检查，比较两者气胸的发生率、有症状者比例、惠肺受压比例、处理措施及气胸复张情况，从而评价联合麻醉下行经支气管镜钳检活检术的安全性。结果表面麻醉组198例，发生气胸为6例，占比3．03％，经吸氧等保守治疗后，100％复张；联合麻醉组254例，发生气胸8例，占比3．13％，其中6例（75％）经吸氧等保守治疗后肺复张，1例需行胸腔穿刺抽气术后复张（12．5％），另外1例需行胸腔闭式引流后复张（12．5％）。两组间气胸发生率比较差异无统计学意义（P〉0．05）。结论联合麻醉下行经纤支镜钳检活检术并发气胸的概率与单纯表面麻醉的相当，说明联合麻醉下行经纤支镜钳检活检是安全的。Objective Compared the incidence of pneumothorax intrans bronchial forceps biopsy of the pure surface anesthesia and that of the surface anesthesia combined with intravenous anesthesia（hereinafter called the combined anesthesia） to assess the safety of the latter. Methods There were a total of 452 cases did trans bronchial forceps biopsy from August to October in 2012 and in 2013 ,including 198 cases with surface anesthesia 254 cases with surface anesthesia combined anesthesia, postoperative chest X-ray and chest CT examination were took after operation, the incidence of symptomatic patients, proportion, lung compression ratio, treatment measures and pneumothorax recruitment situation were compared to evaluate the safety of the bronchoscopy forceps biopsy through the the surface anesthesia combined anesthesia. Results Among 198 cases with surface anesthesia,6 cases appeared pneumothorax with the ratio as 3.03 %, gave the oxygen and other conservative treatment, 100 % lung recruited; 254 cases in combined anesthesia group,8 cases appeared pneumothorax accounted for more than 3.13 % ,in which 6 cases（75 % ） lung recruited after giving oxygen inhalation and other conservative treatment, 1 patients needed thoracic puncture aspiration for reexpansion（12.5 % ）, another 1 cases of closed thoracic drainage required reexpansion（12.5 % ）. There were no statistically significant differences between the two groups（P〉0.05）. Conclusion The incidence of pneumothorax intrans bronchial forceps biopsy of the pure surface anesthesia combined with intravenous anesthesia meets that of the simple surface anesthesia,it shows that the combined anesthesia via fiberoptic bronchoscopy forceps biopsy is safe.

关 键 词：麻醉方式 支气管镜 活检 气胸 

分 类 号：R816.41[医药卫生—放射医学]