环泊酚复合瑞芬太尼在肺结核患者纤维支气管镜检查中的麻醉效果研究  

Anesthetic Effect of Ciprofol Combined with Remifentanil in Fiberoptic Bronchoscopy for Patients with Pulmonary Tuberculosis

作　　者：张悦 杨丽 陈星曲 余得水[2] 张朝贵[2] Zhang Yue;Yang Li;Chen Xingqu;Yu Deshui;Zhang Chaogui(School of Clinical Medicine,North Sichuan Medical University,Nanchong 637000,China;The Second People's Hospital of Yibin,Yibin 644000,China)

机构地区：[1]川北医学院临床医学院,南充637000 [2]宜宾市第二人民医院,宜宾644000

出　　处：《成都医学院学报》2025年第2期256-260,共5页Journal of Chengdu Medical College

基　　金：四川省科技厅自然科学基金面上项目(No:22NSFSC0599)。

摘　　要：目的 探究环泊酚联合瑞芬太尼在肺结核患者无痛纤维支气管镜检查中的麻醉效果。方法 选取宜宾市第二人民医院2024年8-12月需行纤维支气管镜检查的肺结核患者40例作为研究对象,采用随机数字表法将患者分为C组和H组,其中C组无痛方案采用丙泊酚2 mg/kg联合瑞芬太尼0.5μg/kg, H组无痛方案采用环泊酚0.4 mg/kg联合瑞芬太尼0.5μg/kg。比较麻醉诱导前(T0),麻醉诱导后(T1),纤支镜进镜时(T2),纤支镜入隆突后(T3)以及患者离开检查室前(T4)等不同时点心率(HR),血压(BP),脉搏氧饱和度(SPO_(2))以及呼吸频率(RR)变化;比较诱导时长和苏醒时长,操作中药物追加次数以及不良反应发生率。结果 HR比较,H组T4时较T0时稍升高(P<0.05),H组T3及T4时较C组升高(P<0.05);SPO_(2)比较,C组T1、T2、T3时均较T0时降低(P<0.05);SBP比较,C组和H组T1~T4时均较T0时降低(P<0.05),在T1~T3时C组较H组降低更明显(P<0.05);DBP比较,C组在T1~T4时均较T0时降低(P<0.05),H组在T1~T3时均较T0时降低(P<0.05),在T1和T4时C组较H组降低更明显(P<0.05);RR比较,C组在T2及T3时较T0时升高(P<0.05),H组在T1~T4时均高于T0时(P<0.05),且较C组也明显升高(P<0.05)。诱导时长比较,H组较C组明显缩短(P<0.05);苏醒时长比较,H组较C组延长(P<0.05)。操作过程中H组追加药物较C组明显减少(P<0.05)。H组呛咳评分、注射痛及低血压等不良反应均少于C组(P<0.05);H组患者满意度评分高于C组(P<0.05)。结论 环泊酚在肺结核患者纤维支气管镜检查中可以获得满意的麻醉效果,对血流动力学影响小,呛咳反应、注射痛及低血压等不良反应少。Objective To explore the anesthetic effect of ciprofol combined with remifentanil in fiberoptic bronchoscopy for patients with pulmonary tuberculosis(TB).Methods A total of 40 patients with TB undergoing fiberoptic bronchoscopy in The Second People's Hospital of Yibin from August 2024 to December 2024 were selected as the study objects.They were randomly divided into group C and group H,with 20 cases in each group.For anesthesia induction,group C was intravenously injected with propofol 2 mg/kg combined with remifentanil 0.5μg/kg,while group H was intravenously injected with ciprofol 0.4 mg/kg combined with remifentanil 0.5μg/kg.The heart rate(HR),systolic and diastolic blood pressure(SBP/DBP),pulse oxygen saturation(SPO_(2))and respiratory rate(RR)before anesthesia induction(T0),after anesthesia induction(T1),at the time of fiberoptic bronchoscopy entry(T2),after fiberoptic bronchoscopy entry into carinal process(T3)and before patients left the examination room(T4)were compared.The duration of anesthesia induction and recovery,the number of times of drug supplementation during operation and the incidence of adverse reactions were compared between the two groups.Results HR at T4 in group H was slightly higher than that at T0(P<0.05),and HR in group H was higher than that in group C at T3 and T4(P<0.05).SPO_(2) at T1,T2 and T3 in group C was lower than that at T0(P<0.05).SBP at T1-T4 in both groups was lower than that at T0(P<0.05),and the decrease at T1-T3 in group C was more obvious than that in group H(P<0.05).DBP at T1-T4 in group C was lower than that at T0(P<0.05),DBP at T1-T3 in group H was lower than that at T0(P<0.05),and DBP at T1 and T4 in group C was lower than that in group H(P<0.05).RR at T2 and T3 in group C was higher than that at T0(P<0.05),and RR at T1-T4 in group H was higher than that at T0(P<0.05),and was also higher than that in group C(P<0.05).The duration of induction in group H was shorter than that in group C(P<0.05).The recovery time in group H was longer than that in group C(P<0.05).T

关 键 词：环泊酚 瑞芬太尼 肺结核 纤维支气管镜 

分 类 号：R521[医药卫生—内科学]