艾司氯胺酮联合丙泊酚用于危重症患者无痛纤维支气管镜检查中的有效性及安全性  

Efficacy and safety of esketamine combined with propofol in critically ill patients undergoing painless fiberoptic bronchoscopy

作　　者：李青 邹晓东 LI Qing;ZOU Xiaodong(Yangzhou University,Yangzhou 225000;Jinhu County People's Hospital,Huai'an 211600;Affiliated Hospital of Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学,江苏扬州225000 [2]金湖县人民医院,江苏淮安211600 [3]扬州大学附属医院,江苏扬州225000

出　　处：《临床医学研究与实践》2024年第28期91-94,共4页Clinical Research and Practice

摘　　要：目的 观察艾司氯胺酮联合丙泊酚用于危重症患者无痛纤维支气管镜(FOB)检查中的有效性及安全性。方法 选择2021年2月至2022年10月行无痛FOB检查的80例危重症患者,按照随机数字表法将其分为对照组和观察组,各40例。两组均静脉泵入丙泊酚行麻醉诱导,对照组静脉注射芬太尼,观察组静脉注射艾司氯胺酮。比较两组不同时间的收缩压(SBP)、舒张压(DBP)、心率(HR)、呼吸频率(RR)、血氧饱和度(SpO_(2));比较两组干预前、干预后8 h的白细胞介素-6(IL-6)和C-反应蛋白(CRP)水平;比较两组的不良事件发生情况。结果 静脉注射芬太尼或艾司氯胺酮1 min时(T_(1))、检查结束5 min(T_(3)),观察组的SBP、DBP、HR、RR高于对照组(P <0.05);支气管镜置入近气管隆突处(T_(2)),观察组的SBP、HR、RR低于对照组(P<0.05);T_(1)~T_(3),观察组的SpO_(2)高于对照组(P<0.05)。干预前、干预后8 h,两组的IL-6、CRP水平无显著差异(P>0.05)。观察组的低血压、心动过缓、低氧饱和度、RR下降发生率低于对照组(P<0.05);两组的憋气反应、呛咳反应、体动反应发生率无显著差异(P>0.05)。结论 艾司氯胺酮联合丙泊酚应用于ICU危重症患者床边无痛FOB检查中的效果显著,患者血流动力学更稳定、不良反应发生率更低。Objective To observe the efficacy and safety of esketamine combined with propofol in critically ill patients undergoing painless fiberoptic bronchoscopy(FOB).Methods A total of 80 critically ill patients who underwent painless FOB from February 2021 to October 2022 were selected and divided into control group and observation group according to the random number table method,with 40 cases in each group.Both groups were intravenously pumped with propofol for anesthesia induction,the control group was intravenously injected with fentanyl,and the observation group was intravenously injected with esketamine.The systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),respiratory rate(RR)and peripheral capillary oxygen saturation(SpO_(2))were compared between the two groups at different times;the levels of interleukin-6(IL-6)and C-reactive protein(CRP)before intervention and 8 h after intervention were compared between the two groups;the incidence of adverse events was compared between the two groups.Results At 1 min after intravenous injection of fentanyl or esketamine(T_(1))and 5 min after the end of the examination(T_(3)),the SBP,DBP,HR and RR in the observation group were higher than those in the control group(P<0.05);when bronchoscopy is placed near the tracheal carina(T_(2)),the SBP,HR and RR in the observation group were lower than those in the control group(P<0.05);from T_(1) to T_(3),the SpO_(2) in the observation group was higher than that in the control group(P<0.05).Before and 8 h after intervention,there were no significant differences in IL-6 and CRP levels between the two groups(P>0.05).The incidences of hypotension,bradycardia,low oxygen saturation and decreased RR rate in the observation group were lower than those in the control group(P<0.05);there were no significant differences in the incidences of suffocation reaction,cough reaction and body movement reaction between the two groups(P>0.05).Conclusion The esketamine combined with propofol in bedside painless FOB of critically ill pa

关 键 词：纤维支气管镜 艾司氯胺酮 丙泊酚 芬太尼 

分 类 号：R614[医药卫生—麻醉学]