瑞马唑仑联合右美托咪定应用于老年纤维支气管镜检查患者的临床研究  

Clinical study of rimazolam combined with dexmedetomidine in elderly patients undergoing fiberoptic bronchoscopy

作　　者：付世欧[1] 秦培娟[1] 王筱茜 滕娜[1] 艾登斌[1] 刘军超[1] Fu Shiou;Qin Peijuan;Wang Xiaoqian;Teng Na;Ai Dengbin;Liu Junchao(Department of Anesthesia and Surgery,Qingdao Municipal Hospital,Shandong Qingdao 266011,China;Operating Room,Affiliated Hospital of Qingdao University,Shandong Qingdao 266003,China)

机构地区：[1]山东省青岛市市立医院麻醉手术科,山东青岛266011 [2]青岛大学附属医院手术室,山东青岛266003

出　　处：《中国医刊》2023年第8期862-865,共4页Chinese Journal of Medicine

基　　金：山东省医学会舒适化医疗科研基金(YXH2020ZX036)。

摘　　要：目的观察瑞马唑仑联合右美托咪定应用于老年纤维支气管镜检查患者的安全性和有效性。方法选取山东省青岛市市立医院2021年5月至2022年4月收治的120例拟行纤维支气管镜检查的老年患者为研究对象,采用随机数字表法分为A组、B组和C组,每组40例。A组给予丙泊酚+右美托咪定,B组给予瑞马唑仑,C组给予瑞马唑仑+右美托咪定。比较分析三组患者进入手术室后(T0)、麻醉诱导后(T_(1))、纤维支气管镜入声门后(T_(2))、纤维支气管镜入隆突后(T_(3))、入隆突后5min(T_(4))以及检查结束时(T_(5))的血流动力学水平[平均动脉压(mean arterial pressure,MAP)、心率(heart rate,HR)],满意度评分、呛咳次数、苏醒时间,以及检查过程中的不良反应发生情况。结果T_(1)、T_(2)、T_(3)时刻,B组和C组患者的MAP均显著高于A组(P<0.05);T_(4)、T_(5)时刻,C组患者的MAP均显著高于A组(P<0.05);T_(5)时刻,C组患者的MAP显著高于B组(P<0.05)。T_(1)、T_(2)时刻,B组患者的HR显著高于A组和C组(P<0.05);T_(3)、T_(4)时刻,B组和C组患者的HR均显著高于A组(P<0.05)。A组和C组患者的呛咳次数、苏醒时间均显著少于或短于B组(P<0.05);C组的内镜医师满意度评分显著高于A组和B组(P<0.05)。B组和C组患者检查过程中的呼吸抑制、心动过缓以及低血压发生率均显著低于A组(P<0.05)。结论瑞马唑仑复合右美托咪定可维持老年纤维支气管镜检查患者的血流动力学水平稳定,减少呛咳次数,缩短苏醒时间,提高内镜医师满意度,且安全性较好。Objective To observe the safety and efficacy of remazolam combined with dexmedetomidine in elderly patients undergoing fiberoptic bronchoscopy.Method 120 elderly patients with fiberoptic bronchoscopy who were admitted to Qingdao Municipal Hospital from May 2021 to April 2022 were selected as the study objects.They were divided into group A,group B and group C by random number table method,with 40 cases in each group.Group A was given propofol and dexmedetomidine,group B was given remazolam,and group C was given remazolam and dexmedetomidine.The hemodynamic levels(MAP,HR)after entering the operating room(T0),after anesthesia induction(T_(1)),after bronchoscopy into the acoustic door(T_(2)),after bronchoscopy into the carina(T_(3)),5min after bronchoscopy into the carina(T_(4))and at the end of the examination(T_(5)),satisfaction score,coughing times,recovery time,and the occurrence of adverse reactions during the examination were compared and analyzed of the three groups.Result At T_(1),T_(2)and T_(3),MAP in group B and group C was significantly higher than that in group A(P<0.05).At T_(4),T_(5),MAP in group C was significantly higher than that in group A(P<0.05).At T_(5),MAP in group C was significantly higher than that in group B(P<0.05).At T_(1),T_(2),HR in group B was significantly higher than that in group A and group C(P<0.05).At T_(3),T_(4),HR in group B and group C was significantly higher than that in group A(P<0.05).The coughing times and recovery time in group A and group C were significantly less or shorter than those in group B(P<0.05).The satisfaction score of endoscopists in group C was significantly higher than that in group A and group B(P<0.05).The incidences of respiratory depression,bradycardia and hypotension in group B and group C were significantly lower than those in group A(P<0.05).Conclusion Remazolam combined with dexmedetomidine can maintain the stable hemodynamic level of elderly patients with fiberoptic bronchoscopy,reduce coughing times,shorten recovery time,improve the satisfaction

关 键 词：纤维支气管镜 右美托咪定 丙泊酚 瑞马唑仑 

分 类 号：R614[医药卫生—麻醉学]