纤支镜引导下七氟醚麻醉在困难气道插管患者中的应用  

Application of Sevoflurane Anesthesia Guided by Bronchoscopy in Patients With Difficult Airway Intubation

作　　者：李鹏 LI Peng(Department of Anesthesiology,Hengyang Central Hospital,Hengyang Hu’nan 421000,China)

机构地区：[1]衡阳市中心医院麻醉科,湖南衡阳421000

出　　处：《中国卫生标准管理》2022年第14期120-124,共5页China Health Standard Management

摘　　要：目的分析在纤维支气管镜引导下使用七氟醚表面麻醉后对困难气道插管的效果。方法选择衡阳市中心医院2020年1月-12月70例困难气道患者作为研究对象,将其经抽签法均分为对照组和观察组,分别给予右美托咪定、七氟醚,两组均在纤维支气管镜引导下进行表面麻醉,对比两组患者血流动力学指标、一次成功率、满意度、插管不良反应发生率及插管镇静评分。结果插管后观察者平均动脉压、血样饱和度及心率低于对照组,差异有统计学意义(P<0.05);一次成功率及总满意度观察组(100%,97.14%)均高于对照组(82.85%,82.86%),差异有统计学意义(P<0.05);不良反应总发生率观察组(8.57%)低于对照组(28.57%),差异有统计学意义(P<0.05);插管时观察组镇静评分高于对照组,差异有统计学意义(P<0.05)。结论困难气道插管在纤维支气管镜引导下配合使用七氟醚进行表面麻醉应用效果较好,能够保持患者血流动力学相关指标的稳定,提高镇静效果及插管成功率,减少不良反应发生率,且满意度较高,建议使用。Objective To analyze the effect of sevoflurane topical anesthesia under the guidance of fiberoptic bronchoscope on difficult airway intubation.Methods 70 patients with difficult airway in Hengyang Central Hospital from January to December 2020 were selected as the research objects.They were divided into control group and observation group by lot drawing and were given dexmedetomidine and sevoflurane respectively.Both groups were given surface anesthesia under the guidance of fiberoptic bronchoscope.The hemodynamic indexes,one-time success rate,satisfaction,incidence of adverse reaction of intubation and sedation score of intubation were compared between the two groups.Results After intubation,the mean arterial pressure,blood saturation and heart rate of the observer were lower than those of the control group,and the difference was statistically significant(P<0.05);the one-time success rate and total satisfaction in the observation group(100%,97.14%)were higher than those in the control group(88.57%,82.86%),and the difference was statistically significant(P<0.05);the total incidence of adverse reactions in the observation group(8.57%)was lower than that in the control group(28.57%),and the difference was statistically significant(P<0.05);the sedation score of the observation group was higher than that of the control group during intubation,and the difference was statistically significant(P<0.05).Conclusion Difficult airway intubation under the guidance of fiberoptic bronchoscope combined with sevoflurane for topical anesthesia has a better effect,which can maintain the stability of patients'hemodynamic related indicators,improve the sedative effect and intubation success rate,and reduce adverse reactions.The incidence rate is high,and the satisfaction is high,so it is recommended to use it.

关 键 词：七氟醚 纤维支气管镜 表面麻醉 困难气道 插管 右美托咪定 

分 类 号：R614[医药卫生—麻醉学]